Skip to main content
. Author manuscript; available in PMC: 2024 Feb 7.
Published in final edited form as: J Am Coll Cardiol. 2023 Feb 7;81(5):505–514. doi: 10.1016/j.jacc.2022.08.814

CENTRAL ILLUSTRATION. Management Algorithm for Obstructive and Nonobstructive Coronary Causes of Angina.

CENTRAL ILLUSTRATION

A more inclusive management paradigm for stable coronary artery disease (CAD) patients that addresses the many pathogenetic mechanisms responsible for angina and ischemia is necessary to identify diagnostic and therapeutic approaches that would better tailor the appropriate treatment of obstructive and nonobstructive causes of myocardial ischemia to the underlying ischemia precipitants. Such an approach seeks to promote both evidence-based pharmacologic secondary prevention and procedural interventions as complementary and potentially additive treatments to optimize the management of stable angina patients. ACh = acetylcholine; CCTA = coronary computed tomography angiography; CFR = coronary flow reserve; CV = cardiovascular; FFR = fractional flow reserve (a hyperemic pressure ratio);GDMT = guideline-directed medical therapy; iFR = instantaneous free wave ratio; IMR = index of microvascular resistance; LMD = left main disease.