Ischaemia with no obstructive coronary arteries

R. E. Konst, J. G. Meeder, M. E. Wittekoek, A. H.E.M. Maas, Y. Appelman, J. J. Piek, T. P. van de Hoef, P. Damman, S. E. Elias-Smale

Research output: Contribution to journalReview articleAcademicpeer-review

19 Citations (Scopus)


Ischaemia with no obstructive coronary arteries (INOCA) is a common ischaemic heart disease with a female preponderance, mostly due to underlying coronary vascular dysfunction comprising coronary microvascular dysfunction and/or epicardial coronary vasospasm. Since standard ischaemia detection tests and coronary angiograms are not suitable to diagnose coronary vascular dysfunction, INOCA is often overlooked in current cardiology practice. Future research, including large outcome trials, is much awaited. Yet, adequate diagnosis is possible and treatment options are available and vital to reduce symptoms and most probably improve cardiovascular prognosis. This review intends to give a brief overview of the clinical presentation, underlying pathophysiology, and the diagnostic and treatment options in patients with suspected INOCA.

Original languageEnglish
Pages (from-to)66-72
Number of pages7
JournalNetherlands heart journal
Publication statusPublished - 1 Aug 2020


  • Coronary vascular dysfunction
  • Coronary vasospasm
  • Gender
  • Microvascular angina

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