Coronary microvascular disease: coronary flow reserve and the complementary role of positron emission tomography and angiography

We present the case of a woman in her 30s with chronic residual chest pain accompanied by dyspnoea on exertion despite multiple evaluations and cardiac testing over a period of nearly 14 years. Ultimately, she underwent N-13 Ammonia positron emission tomography (PET) myocardial perfusion imaging, wh...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2022-03, Vol.15 (3), p.e248354
Main Authors: Aun, Jonathan A, Hulten, Edward, Saad, Elie
Format: Article
Language:English
Subjects:
Case Reports: Reminder of important clinical lesson
Coronary Angiography
Female
Fractional Flow Reserve, Myocardial
Humans
Microvascular Angina
Positron-Emission Tomography - methods
Tomography, X-Ray Computed
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We present the case of a woman in her 30s with chronic residual chest pain accompanied by dyspnoea on exertion despite multiple evaluations and cardiac testing over a period of nearly 14 years. Ultimately, she underwent N-13 Ammonia positron emission tomography (PET) myocardial perfusion imaging, which demonstrated mild three-vessel microvascular disease. Coronary microvascular disease (CMD) plays a major role in determining myocardial ischaemia in many cardiovascular conditions. The diagnosis relies on indirect measurement of coronary flow reserve (CFR), which may be evaluated both invasively and non-invasively. Assessing CFR not only allows for successful diagnosis of CMD but holds powerful prognostic value for cardiovascular mortality. PET myocardial perfusion imaging is a complementary tool to coronary angiography to achieve diagnosis in a non-invasive, highly accurate and reproducible manner.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-248354