Drug administered | Results | Diagnosis |
---|---|---|
1. Adenosine | Coronary flow reserve < 2.5 | Nonendothelial-dependent microvascular dysfunction |
2. Acetylcholine | < 50% increase in coronary blood flow | Endothelial-dependent microvascular dysfunction |
< 5% increase in coronary artery diameter | Endothelial-dependent macrovascular dysfunction | |
> 90% decrease in coronary artery diameter Chest pain and ischemic ST-segment changes on electrocardiography | Epicardial coronary spasm | |
Chest pain and ischemic ST-segment changes on electrocardiography in the absence of significant epicardial coronary vasoconstriction | Microvascular coronary spasm | |
3. Nitroglycerin | < 20% increase in coronary artery diameter | Nonendothelial-dependent macrovascular dysfunction |
INOCA = ischemia and no obstructive coronary artery disease (ie, < 50% stenosis)