Professor Juan Carlos Kaski, Director of the Cardiovascular and Cell Sciences Research Institute at St George’s University of London, UK

Microvascular angina is associated with a reduction in blood flow caused by constriction of the small arteries or the inability of the arteries to dilate. Here, at the ESC 2015, Professor Juan Carlos Kaski, talks about how improving the function of the arteries will prevent coronary artery spasm.


Microvascular angina is a condition which affects a fairly large amount of people. This condition is essentially based on the presence of reduction in blood flow, caused by either constriction of the arteries of a lack of an ability for these arteries to dilate. And this happens in the presence of completely normal coronary arteries, which is something that has puzzled physicians throughout the years.

For many years the condition was not believed to be a real one, and only a few aficionados would actually be keen to propose this diagnosis. But nowadays we have obtained a fairly good deal of evidence that actually allows us to say categorically that microvascular dysfunction leading to microvascular angina is a condition that needs to be treated.

Identifying the condition is number one in terms of treating the patient. The second is to find out why the patient has microvascular angina. And there are many tests that we can use in clinical practice to detect that. But once we have identified that the patient is normal, they have angina and there are objective evidences for the presence of myocardial ischemia then we really need to treat these patients accordingly.

Many cardiologists still dismiss the idea that the individual has chest pain due to coronary problem, mainly because the arteries are normal. But we now know that there are specific conditions and that is basically improving the function of the arteries and preventing coronary artery spasm.