Canadian Journal of Cardiology

Stress Echocardiography in the Diagnosis of Coronary Microvascular Ischemia: The Forgotten Old Faithful Tool?

      Ischemia is defined as an imbalance between myocardial oxygen supply and demand—this includes both macrovascular and microvascular ischemia. When patients present with typical angina or equivalents, a clinician can use a battery of tests to assess for ischemia. If positive and symptomatic despite medical therapy, patients are referred for coronary angiography to detect significant epicardial coronary artery disease (CAD) as a cause of symptoms.
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        • Vancheri F.
        • Longo G.
        • Vancheri S.
        • Henein M.
        Coronary microvascular dysfunction.
        J Clnic Med. 2020; 9: 2880
        • Mathew R.C.
        • Bourque J.M.
        • Salerno M.
        • Kramer C.M.
        Cardiovascular imaging techniques to assess microvascular dysfunction.
        JACC Cardiovasc Imaging. 2020; 13: 1577-1590
        • Al-Mohaissen M.A.
        Echocardiographic assessment of primary microvascular angina and primary coronary microvascular dysfunction [e-pub ahead of print].
        Trends Cardiovasc Med. 2022 Feb 19;
        • Gulati M.
        • Levy P.D.
        • Mukherjee D.
        • et al.
        2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
        Circulation. 2021; 144: e368-e454
        • Shah S.J.
        • Lam C.S.P.
        • Svedlund S.
        • Saraste A.
        • Hage C.
        • Tan R.S.
        • et al.
        Prevalence and correlates of coronary microvascular dysfunction in heart failure with preserved ejection fraction: PROMIS-HFpEF.
        Eur Heart J. 2018; 39: 3439-3450