Figure 1.

In addition to the ‘classic mechanisms’ (i.e. atherosclerotic disease and vasospastic disease) that lead to myocardial ischaemia, coronary microvascular dysfunction (CMD) has recently emerged as a ‘third’ potential mechanism of myocardial ischaemia. As in the case of the other two mechanisms, coronary microvascular dysfunction (alone or in combination with the other two) can lead to transient myocardial ischaemia as in patients with coronary artery disease (CAD) or cardiomyopathy (CMP) or to severe acute ischaemia as observed in Takotsubo syndrome. CFR, coronary flow reserve.