Myocardial ischemia: From disease to syndrome

Mario Marzilli*, Filippo Crea, Doralisa Morrone, Robert O. Bonow, David L. Brown, Paolo G. Camici, William M. Chilian, Anthony DeMaria, Giacinta Guarini, Alda Huqi, C. Noel Bairey Merz, Carl Pepine, Maria Chiara Scali, William S. Weintraub, William E. Boden

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Although current guidelines on the management of stable coronary artery disease acknowledge that multiple mechanisms may precipitate myocardial ischemia, recommended diagnostic, prognostic and therapeutic algorithms are still focused on obstructive epicardial atherosclerotic lesions, and little progress has been made in identifying management strategies for non-atherosclerotic causes of myocardial ischemia. The purpose of this consensus paper is three-fold: 1) to marshal scientific evidence that obstructive atherosclerosis can co-exist with other mechanisms of ischemic heart disease (IHD); 2) to explore how the awareness of multiple precipitating mechanisms could impact on pre-test probability, provocative test results and treatment strategies; and 3) to stimulate a more comprehensive approach to chronic myocardial ischemic syndromes, consistent with the new understanding of this condition.

Original languageEnglish (US)
Pages (from-to)32-35
Number of pages4
JournalInternational Journal of Cardiology
StatePublished - Sep 1 2020


  • Angina
  • Chronic coronary syndromes
  • Coronary artery disease
  • Ischemic heart disease
  • Microvascular dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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