Angina pectoris with a normal coronary angiogram

Eric H. Yang, Amir Lerman

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


Angina in the setting of a normal angiogram (NOCAD) occurs in 20-30% of patients undergoing coronary angiography. The etiologies of NOCAD can be anatomically classified into three groups: epicardial disease, coronary microvascular dysfunction, and noncoronary disease. Epicardial disease resulting in NOCAD includes endothelial dysfunction, coronary artery spasm, and coronary artery bridging. Microvascular dysfunction maybe secondary to hypertension, cardiomyopathy, infiltrative disease, valvular disease, or idiopathic. Noncoronary artery disease states involving other organs systems such as the pulmonary, gastrointestinal, or musculoskeletal systems can also result in NOCAD. This review focuses on the coronary etiologies of NOCAD. The pathophysiology of disease is discussed as well as a systematic diagnostic strategy. Potential therapeutic options and prognosis are also reviewed.

Original languageEnglish (US)
Pages (from-to)17-25
Number of pages9
Issue number1
StatePublished - Feb 1 2005


  • Angina
  • Coronary spasm
  • Endothelial dysfunction
  • Microvascular dysfunction
  • Normal angiogram

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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