Affiliation:
1. Department of Intensive Care Unit, General Hospital of Nova Gorica , Padlih borcev 13A , Šempeter pri Gorici 5290, Slovenia
2. Department of Cardiology, University Medical Centre , Ljubljana , Slovenia
Abstract
Abstract
Background
Coronary artery disease has a long preclinical phase before manifesting itself clinically due to diffuse non-obstructive disease, stenoses, or thrombosis.
Case summary
We present a case of a middle-aged male complaining of atypical chest pain, then severe retrosternal pain, and, eventually, effort angina. We performed non-invasive testing, coronary angiography, intravascular imaging, and flow reserve tests, each as appropriate. Cardiovascular risk control, optimization of drug therapy, and percutaneous coronary intervention were considered trying to comply with the best clinical practice.
Discussion
Diffuse non-obstructive coronary artery disease may present clinically in different ways. Exercise stress test might be sufficient to assess effort angina before a potential angiography. Flow reserve tests across the diseased vessel can distinguish between diffuse and focal pattern of the disease and assist in the adequate selection of therapy. Finally, intravascular imaging is invaluable for the assessment of the plaque risk features.
Publisher
Oxford University Press (OUP)
Subject
Cardiology and Cardiovascular Medicine