Figure 1.

Etiology of chest pain without obstructive coronary artery disease.

The differential diagnosis of chest pain with no obstructive coronary artery disease is broad. If signs and symptoms point to angina, then abnormal coronary vascular dysfunction should be considered. Vascular mechanisms include coronary vasospasm (macro and microvascular spasm), coronary endothelial dysfunction, coronary microvascular dysfunction, capillary obstruction, or rarefaction. Image created using Biorender.com.