1. ANOCA: From Angina to Diagnosis and Tailored Treatment<\/p>\n
Non-Obstructive Coronary Syndromes \u2014 Part 1<\/p>\n
Sources: Featured in TCTMD \u2014 August 4, 2026; TRI-NOCA Study \u2014 EuroIntervention, July 2026; ESC Chronic Coronary Syndromes Guidelines, 2024.<\/p>\n
Key Points
\n* Patient presents with typical\/recurrent angina \u2192 assess cardiovascular risk and exclude other causes of chest pain.
\n* Evaluate for coronary artery disease (CAD) with appropriate non-invasive testing and\/or coronary angiography.
\n* Coronary angiography shows no significant obstructive CAD \u2192 consider ANOCA (Angina with Non-Obstructive Coronary Arteries) rather than automatically labeling the symptoms as \u201cnon-cardiac.\u201d
\n* Look for objective evidence of ischemia, when appropriate, using stress echo, PET\/SPECT, or stress Cardiac Magnetic Resonance (CMR). If ischemia is demonstrated without obstructive CAD \u2192 INOCA (Ischemia with Non-Obstructive Coronary Arteries).
\n* A = Angina \u2192 symptom
\n* I = Ischemia \u2192 objective evidence
\n* If symptoms persist or the mechanism remains unclear \u2192 invasive coronary functional testing, ideally during the same angiographic procedure when available:
\n* Adenosine \u2192 assesses Coronary Flow Reserve (CFR), the ability of coronary blood flow to increase when needed, and Index of Microcirculatory Resistance (IMR), the resistance within the coronary microcirculation. Abnormal results can identify Coronary Microvascular Dysfunction (CMD).
\n* Acetylcholine \u2192 identifies epicardial coronary spasm or microvascular spasm.
\n* MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries) is a different clinical presentation: myocardial infarction without significant obstructive CAD.<\/p>\n
Simply:
\nANOCA = Angina \u2192 INOCA = Ischemia \u2192 MINOCA = Myocardial Infarction, all in the setting of non- obstructive coronary arteries.
\nhttps:\/\/www.tctmd.com\/news\/anoca-endotyping-bolsters-qol-real-world-data-confirm<\/p>\n","protected":false},"excerpt":{"rendered":"
1. ANOCA: From Angina to Diagnosis and Tailored Treatment Non-Obstructive Coronary Syndromes \u2014 Part 1 Sources: Featured in TCTMD \u2014 August 4, 2026; TRI-NOCA Study \u2014 EuroIntervention, July 2026; ESC Chronic Coronary Syndromes Guidelines, 2024. Key Points * Patient presents with typical\/recurrent angina \u2192 assess cardiovascular risk and exclude other causes of chest pain. * […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-10471","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/10471","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=10471"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/10471\/revisions"}],"predecessor-version":[{"id":10472,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/10471\/revisions\/10472"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=10471"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=10471"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=10471"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}