Fig. 7. Case example of microvascular disease.
69-year-old female patient presented with stable angina. Despite positive exercise stress test (ST segment depression in inferior and lateral leads) (A), there was no significant coronary artery stenosis (B). Invasive physiologic assessment was performed and fractional flow reserve, coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) were 0.94, 1.4, and 39, respectively (C). As there was no significant epicardial disease (high fractional flow reserve), low CFR and high IMR indicate presence of microvascular disease.