The initial descriptions of angina

The initial descriptions of angina developing in the absence of CAD gave rise to the rather ill-defined concepts of chest pain with normal coronary arteries or cardiac syndrome X.15–17 The term microvascular angina (MVA) was originally proposed by Cannon and Epstein16 in 1988 to describe patients with normal coronary arteriograms and evidence of myocardial ischemia caused by a disorder of the coronary microvasculature. The term MVA has gained acceptance over other denominations to define patients with angina despite nonobstructive CAD or with completely normal coronary angiograms. It could be argued, however, as it will be elaborated throughout –this article, that the term MVA should be applicable to all forms of angina/ischemia triggered by CMD despite the absence or presence of CAD, rather than restricting the term to conditions characterized by myocardial ischemia in the absence of obstructive CAD.