Stable microvascular angina: instrumental evaluation of coronary microvascular dysfunction with coronary angiography and myocardial scintigraphy

Stable microvascular angina (SMVA) describes a framework in which episodes of angina are exclusively or predominantly related to exertion. During diagnostic investigation, physician notices findings compatible with myocardial ischemia, normal coronary arteries on angiography, absence of any other specific cardiac disease (e.g., variant angina, cardiomyopathy, and valvular disease) [1,2]. The aim of this study is to demonstrate that myocardial ischemia in patients without epicardial artery stenosis, evaluated with nuclear imaging, correlates with alterations of coronary microcirculation. These alterations were evaluated by angiography indices like TIMI Frame Count (TFC), Myocardial Blush Grade (MBG) and Total Myocardial Blush Score (TMBS).