The subendocardial layers of the left ventricular wall are more sensitive to ischemia. Infarcts start in the subendocardium and progressively extend to the mid and subepicardial layers if ischemia is severe and prolonged enough. It is not exclusive of microvascular dysfunction, but of any mechanism that may precipitate myocardial infarction .
Invasive coronary physiology in patients with angina and non obstructive coronary artery disease: a consensus document from the coronary microvascular dysfunction workstream of the British Heart Foundation/National Institute for Health Research Partnership
Physiological Stratification of Patients With Angina Due to Coronary Microvascular Dysfunction
Haseeb Rahman, Ozan M. Demir, Faisal Khan, Matthew Ryan, Howard Ellis, Mark T. Mills, Amedeo Chiribiri, Andrew Webb and Divaka Perera
Lay Summary – 2020 research outlining two different types of Coronary Microvascular Dysfunction and the possible benefits of tailored treatments.
http://www.onlinejacc.org/content/75/20/2538
Testing for Coronary Microvascular Dysfunction
C Noel Bairey Merz
Lay Summary – Discusses the various testing available for CMD
https://jamanetwork.com/journals/jama/fullarticle/2755842
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