53
Factors that Increase
Likelihood of CMD:
• Diabetes,
Hypertension
• Left Ventricular
Hypertrophy
• Small Coronary Vessel
Size or Lumen Volume
• Infiltrative Heart
Disease
No ischemia
+
normal
MBFR
Diagnostic
criteria for
INOCA -
no CMD
Low risk for CV
events
Diagnostic
criteria for
CMD + ischemia
Elevated risk for MACE
Diagnostic
criteria for
CMD
Reduced
MBFR
+
ischemia
Normal
MBFR with
ischemia
Reduced
MBFR
+
no ischemia
Stress PET or stress CMR -
must be with MBFR
(2a)
Stress echocardiography with CFVR
(2b)
Test choice should be guided by local availability and expertise.
* Ford T, et al. J Am Coll Cardiol 2018;72:584-6.
† Cannot exclude microvascular vasospasm.
