Myocardial ischemia: From disease to syndrome.

Myocardial ischemia: From disease to syndrome.

Marzilli Mario; Crea Filippo; Morrone Doralisa; Bonow Robert O; Brown David L; Camici Paolo G; Chilian William M; DeMaria Anthony; Guarini Giacinta; Huqi Alda; Merz C Noel Bairey; Pepine Carl; Scali Maria Chiara; Weintraub William S; Boden William E

International journal of cardiology

2020

2020-04-26

Although current guidelines on the management of stable coronary artery disease acknowledge that multiple mechanisms may precipitate myocardial ischemia, recommended diagnostic, prognostic and therapeutic algorithms are still focused on obstructive epicardial atherosclerotic lesions, and little progress has been made in identifying management strategies for non-atherosclerotic causes of myocardial ischemia. The purpose of this consensus paper is three-fold: 1) to marshal scientific evidence that obstructive atherosclerosis can co-exist with other mechanisms of ischemic heart disease (IHD); 2) to explore how the awareness of multiple precipitating mechanisms could impact on pre-test probability, provocative test results and treatment strategies; and 3) to stimulate a more comprehensive approach to chronic myocardial ischemic syndromes, consistent with the new understanding of this condition.

Angina; Chronic coronary syndromes; Coronary artery disease; Ischemic heart disease; Microvascular dysfunction

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1874-1754 0167-5273

NEOMED College of Medicine

Department of Integrative Medical Sciences

June 2020 Update II