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. 2023 Apr 18;24(4):118. doi: 10.31083/j.rcm2404118

Fig. 2.

Fig. 2.

Clinical case of ischemia with non-Obstructive coronary artery Disease (INOCA). A 70-year-old woman with recurrent hospitalizations with chest pain. High-sensitivity troponin I concentrations measured within the normal sex-specific range (<16 ng/L). The exercise treadmill test was strongly positive for ischemia with widespread horizontal ST-segment depression. The invasive coronary angiogram showed minor atherosclerotic plaque only. CMR stress and rest imaging revealed a circumferential subendocardial perfusion defect, low stress MBF (Global stress MBF = 1.80 mL/min/g) and low MPR (Global MPR = 1.67). The final diagnosis was microvascular angina. Abbreviations: CAD, coronary artery disease; CMR, cardiac magnetic resonance imaging; MBF, myocardial blood flow; MPR, myocardial perfusion reserve. (Acknowledgement to Dr C Bradley, Dr P Kellman and Dr H Xue, National Institutes of Health).