Work

Small vessels, big impact: understanding women’s microvascular heart disease

Year: 2026

Type: review

Abstract: Coronary microvascular dysfunction (CMD), angina with no obstructive coronary arteries (ANOCA), and ischemia with no obstructive coronary arteries (INOCA) are increasingly recognized as key contributors to ischemic heart disease in women, who often present with atypical symptoms and higher symptom burden. CMD arises from structural and functional abnormalities of the coronary microcirculation, resulting in angina, ischemia, and adverse cardiovascular outcomes despite unobstructed epicardial vessels. Accurate, mechanism-based diagnosis using invasive coronary function testing and non-invasive imaging is critical to guide targeted therapy. Management integrates pharmacologic agents with lifestyle and psychosocial interventions. Clinical trials suggest individualized therapy improves symptoms and quality of life, though reductions in major adverse cardiovascular events remain limited. Emerging strategies, including pharmacogenomic approaches, highlight the importance of precision medicine to optimize outcomes in women with CMD, INOCA, and INOCA.

Source: Current Opinion in Physiology

DOI: 10.1016/j.cophys.2026.100903

Authors: Aanchel Gupta, Aanchel Gupta, Arjun K Gupta, Arjun K Gupta

Institution: University of Alberta

Language: English

Topic: Cardiac Imaging and Diagnostics

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,500