Bhogal S, Batta A, Mohan B. Known yet underdiagnosed: Invasive assessment of coronary microvascular disease and its implications. World J Cardiol 2025; 17(1): 100203 [PMID: 39866215 DOI: 10.4330/wjc.v17.i1.100203]
Corresponding Author of This Article
Akash Batta, Associate Professor, MD, Department of Cardiology, Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana 141001, Punjab, India. akashbatta02@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Jan 26, 2025; 17(1): 100203 Published online Jan 26, 2025. doi: 10.4330/wjc.v17.i1.100203
Known yet underdiagnosed: Invasive assessment of coronary microvascular disease and its implications
Sukhdeep Bhogal, Akash Batta, Bishav Mohan
Sukhdeep Bhogal, Department of Cardiology, Sovah Health, Martinsville, VA 24112, United States
Akash Batta, Bishav Mohan, Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
Author contributions: Bhogal S performed the literature review and data collection; Bhogal S and Batta A designed the editorial, analysed the data and wrote the manuscript and subsequently revised it; Bhogal S and Mohan B supervised the manuscript and provided key feedback and suggestions; all authors have read and approved the final manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Akash Batta, Associate Professor, MD, Department of Cardiology, Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana 141001, Punjab, India. akashbatta02@gmail.com
Received: August 9, 2024 Revised: December 22, 2024 Accepted: January 3, 2025 Published online: January 26, 2025 Processing time: 164 Days and 13 Hours
Abstract
Coronary microvascular disease (CMD) is one of the commonest causes of cardiac chest pain. The condition is more prevalent in women, and incidence is known to increase with age, hypertension, and diabetes. The pathophysiological pathways are heterogenous and related to intrinsic vascular and endothelial dysfunction. Furthermore, this entity is known to be associated with adverse cardiovascular outcomes. Despite this, there is inertia amongst cardiologists to further evaluate patients with non-critical coronary artery disease and suspected CMD. With refinement in technology, we have now better understanding of CMD and invasive testing in the catheterization laboratory is a viable option for confirming the diagnosis of CMD. However, despite advances in diagnosing and stratifying this entity, therapeutic options remain limited and poorly defined. In this editorial, we will briefly focus on the pathophysiology and invasive assessment and therapeutic options available for CMD.
Core Tip: Coronary microvascular disease (CMD) is one of the commonest causes of chest pain in outpatient clinics and yet is grossly underappreciated and undertreated. Despite the increasing awareness in cardiology community about CMD, there is still a huge lacuna in our approach to identifying and managing this entity. In this editorial, we review the most recent literature surrounding CMD and in particular we focus on its invasive assessment and diagnosis in the cardiac catheterization laboratory. Further, we discuss how this knowledge will ultimately translate into clinical benefit for the patients and why knowledge about CMD is an absolute necessity in today’s world.
