Benita Tjoe, MD, Lili Barsky, MD, Janet Wei, MD, Bruce Samuels, MD, Babak Azarbal, MD, C. Noel Bairey Merz, MD and Chrisandra Shufelt, MD, MS
Lay Summary – Diagnosis and Treatment in Coronary Microvascular Dysfunction
Hiroaki Shimokawa, Akira Suda, Jun Takahashi, Colin Berry, Paolo G Camici, Filippo Crea, Javier Escaned, Tom Ford, Eric Yii, Juan Carlos Kaski, Takahiko Kiyooka, Puja K Mehta, Peter Ong, Yukio Ozaki, Carl Pepine, Ornella Rimoldi, Basmah Safdar, Udo Sechtem, Kenichi Tsujita, Satoshi Yasuda, John F Beltrame, C Noel Bairey Merz
Lay Summary – An in depth study by COVADIS on clinical characteristics and outcomes for patients with microvascular angina
Francesco Pelliccia, Mario Marzilli, William E. Boden, and Paolo G. Camici
Lay Summary – Making Decisions in MINOCA
Sinha Aish, Rahman Haseeb, Perera Divaka
Lay Summary – Discussing recent advances in understanding CMD, testing, managenent and what the future might hold.
Tom Ford
Lay Summary – Discussing whether invasive testing should be the standard of care for unexplained chest symptoms in the absence of blocked arteries.
https://insightplus.mja.com.au/2021/5/every-chest-pain-deserves-a-diagnosis/
The wall of the blood vessel (coronary artery) supplying the heart muscle has got three layers: the innermost layer contains endothelial cells, the middle layer contains the smooth muscle cells and the outermost layer contains collagen fibres for support.
The endothelial cells naturally release a substance called nitric oxide (NO), that then diffuses along into the neighbouring smooth muscle cells and causes these cells to relax. This leads to the coronary artery dilating, which results in an increased blood flow to the heart muscle. This is an important physiological response to exertion.
Endothelium-dependent CMD essentially means an inability of the endothelial cells to produce nitric oxide. As a result, the smooth muscle cells are unable to relax and the coronary artery is unable to dilate as required. This results in blunted increase in blood flow to the heart muscle during times of stress, which results in angina.
Endothelium-independent (or non-endothelium dependent) CMD refers to an inability of the smooth muscle cells to relax despite an adequate amount of nitric oxide. This, again, results in blunted increase in blood flow to the heart muscle during times of stress, which results in angina.
Therefore, both group of patients have an inability to dilate their coronary arteries in response to stress, which reduces the blood flow to the heart muscle during times of stress, leading to angina
Hirofumi Yasue, Yuji Mizuno, Eisaku Harada
Lay Summary – What it is, how it develops and what the treatments are (2019)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6403432
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