Angina pectoris and ischemia of non-obstructive coronary arteries (ANOCA/INOCA): a clinical case
Received: 2026-02-24 11:35:45
Published: 2026-03-29
Abstract
Non-obstructive angina and ischemia of the coronary arteries (ANOCA/INOCA) is a condition in which there are signs of angina and/or ischemia in the absence of significant obstruction of the coronary arteries. This article presents a clinical case and includes a review of the literature. A 52-year-old female patient presented with typical anginal pain, a positive stress test, and no obstructive changes on coronary angiography. As a result of the analysis, a diagnosis of ANOCA/INOCA (microvascular angina) was made. The pathogenesis, diagnosis, and treatment strategies were reviewed. This case highlights the clinical significance of ANOCA/INOCA and demonstrates the importance of individualized therapy.
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List of references
-
V. Kunadian et al., “An EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International Study Group,” European Heart Journal, vol. 41, no. 37, pp. 3504–3520, Jun. 2020, https://doi.org/10.1093/eurheartj/ehaa503.
-
T. J. Ford et al., “Stratified medical therapy using invasive coronary function testing in angina,” Journal of the American College of Cardiology, vol. 72, no. 23, pp. 2841–2855, Sep. 2018, https://doi.org/10.1016/j.jacc.2018.09.006.
-
C. N. B. Merz et al., “The Women’s Ischemia Syndrome Evaluation (WISE) Study: protocol design, methodology and feasibility report,” Journal of the American College of Cardiology, vol. 33, no. 6, pp. 1453–1461, May 1999, https://doi.org/10.1016/s0735-1097(99)00082-0.
-
J. Knuuti et al., “2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes,” European Heart Journal, vol. 41, no. 3, pp. 407–477, Aug. 2019, https://doi.org/10.1093/eurheartj/ehz425.
-
T. J. Ford et al., “Stratified medical therapy using invasive coronary function testing in angina,” Journal of the American College of Cardiology, vol. 72, no. 23, pp. 2841–2855, Sep. 2018, https://doi.org/10.1016/j.jacc.2018.09.006.
-
B. A. Samuels et al., “Comprehensive Management of ANOCA, Part 1—Definition, patient population, and Diagnosis,” Journal of the American College of Cardiology, vol. 82, no. 12, pp. 1245–1263, Sep. 2023, https://doi.org/10.1016/j.jacc.2023.06.043.
-
L. Viola, M. Masters, U. Shafiq, K. R. Jujjavarapu, and S. Luthra, “Ischemia with No Obstructive Coronary Artery Disease (INOCA): A Review,” Life, vol. 15, no. 10, p. 1554, Oct. 2025, https://doi.org/10.3390/life15101554.
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Copyright (c) 2026 Н.A. Усманова, К.Ф. Улугбердиева, Д.А. Гайназарова, Д.И. Қуддусов (Автор)

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