Features of diagnosis and treatment of coronary heart disease in patients without obstructive atherosclerotic lesions of the coronary arteries

In half of cases during coronary angiography (CAG), obstructive coronary artery lesions aren’t detected in patients with chronic coronary artery disease. Such patients mostly have vasospastic angina (VSA) and/or microvascular angina (MVA). These patients can be performed repeated diagnostic tests, including selective coronary angiography, but as a result they are never diagnosed correctly. This review presents modern pathogenetic mechanisms for the development and methods of diagnosing of ischemia with non-obstructive coronary artery disease. It also highlights choice of treatment tactics in accordance with the identified pathophysiological mechanism for the development of chronic coronary artery disease.