Abstract

Coronary microvascular obstruction and dysfunction from pathophysiology

Author(s): Federico Andreoli, Nicole Carabetta, Leonardo De Luca, Domenico Gabrielli

Although the time to coronary revascularization of patients with acute myocardial infarction with ST-Segment Elevation (STEMI) has been significantly reduced in recent years, the occurrence of Coronary Microvascular Obstruction and dysfunction (CMVO) is still a common complication associated with a worse prognosis. Currently, there are still several questions regarding CMVO, first of all, the diagnostic methods are not yet established and adequately known; the correct quantification and the attribution of a real weight in terms of prognosis are still challenging; despite the numerous therapeutic strategies proposed, by the results of some recent clinical trials are conflicting, so the clinical management of such patients is still a matter of debate. In this review, we analyse the pathophysiological mechanisms of CMVO, possible assessment methods, current pharmacological and mechanical therapeutic strategies, and propose possible future therapeutic perspectives.