Mumma Bryn, Flacke Nathalie
UC Davis Health System Department of Emergency Medicine 4150 V Street, PSSB #2100 Sacramento, CA 9517 USA.
Service des Urgences 2 Rue Schlumberger Guebwiller, F-68500 France.
Curr Emerg Hosp Med Rep. 2015 Mar;3(1):30-37. doi: 10.1007/s40138-014-0059-1.
Microvascular angina is common among patients with signs and symptoms of acute coronary syndrome and is associated with an increased risk of cardiovascular and cerebrovascular events. Unfortunately, microvascular is often under-recognized in clinical settings. The diagnosis of microvascular angina relies on assessment of the functional status of the coronary microvasculature. Invasive strategies include acetylcholine provocation, intracoronary Doppler ultrasound, and intracoronary thermodilution; noninvasive strategies include cardiac positron emission tomography (PET), cardiac magnetic resonance, and Doppler echocardiography. Once the diagnosis of microvascular angina is established, treatment is focused on improving symptoms and reducing future risk of cardiovascular and cerebrovascular events. Pharmacologic options and lifestyle modifications for patients with microvascular angina are similar to those for patients with coronary artery disease.
微血管性心绞痛在有急性冠状动脉综合征体征和症状的患者中很常见，并且与心血管和脑血管事件风险增加相关。不幸的是，微血管性心绞痛在临床环境中常常未得到充分认识。微血管性心绞痛的诊断依赖于对冠状动脉微血管功能状态的评估。有创策略包括乙酰胆碱激发试验、冠状动脉内多普勒超声检查和冠状动脉内热稀释法；无创策略包括心脏正电子发射断层扫描（PET）、心脏磁共振成像和多普勒超声心动图。一旦确诊微血管性心绞痛，治疗重点在于改善症状并降低未来心血管和脑血管事件的风险。微血管性心绞痛患者的药物治疗选择和生活方式改变与冠状动脉疾病患者相似。
