Overview
When a Normal Angiogram Is Not a Normal Coronary Circulation
Chest pain can reflect inadequate myocardial perfusion even when angiography shows no major epicardial blockage.
NCLEX-RN
NCLEX-RN
Chest pain can reflect inadequate myocardial perfusion even when angiography shows no major epicardial blockage. Microvascular angina (MVA) is myocardial ischaemia caused by coronary microvascular dysfunction: the small coronary vessels may fail to dilate, offer excessive resistance, or constrict abnormally while the epicardial arteries remain non-obstructive. MVA is one endotype within angina or ischaemia with non-obstructive coronary arteries (ANOCA/INOCA). “Non-obstructive” describes the visible epicardial lumen; it does not mean that the patient’s symptoms are non-cardiac. A known diagnosis of MVA also does not protect a patient from a future acute coronary syndrome (ACS). A new, prolonged, crescendo, or rest-predominant episode requires urgent ACS assessment.
Unlock full lesson + practice questions
7 more sections with scenarios, priorities, and review drills.
Final rapid review before practice
Next study step
Finish the lesson first, then choose a focused activity to apply what you just reviewed.
Continue studying
Sign in to save progress on this lesson.
Unlock the interactive lesson quiz with a plan that includes this NCLEX-RN pathway. You can still explore topic-filtered questions from the bank hubs below.