Skip to content
Review Open access

A proposal of an echocardiography-based pathway for the diagnosis and management of angina with no obstructive coronary arteries: a state-of-the-art review

Jul 2026 · European heart journal. Imaging methods and practice · Vol 4 · 0 citations · 80 references
Medicine

TL;DR

The review is providing with the critical appraisal of the current invasive and non-invasive imaging modalities before the proposal of a fully non-invasive echocardiography-based pathway to identify ANOCA endotypes to allow delivery of targeted therapy for symptom control to avoid recurrent hospital admissions.

Abstract

Abstract In this paper we are discussing the currently available tools in the diagnosis of angina with non-occlusive coronary artery disease (ANOCA) a potentially disabling condition that affects approximately 30–60% of patients with angina. With the advancement in ultrasound technology, multi-parametric stress echocardiography in combination with hyperventilation provocation echocardiography lends itself as a bedside, scalable, safe and cost-effective test to triage patients who may require downstream invasive functional coronary angiography. The review is providing with the critical appraisal of the current invasive and non-invasive imaging modalities before the proposal of a fully non-invasive echocardiography-based pathway to identify ANOCA endotypes to allow delivery of targeted therapy for symptom control to avoid recurrent hospital admissions and to monitor treatment effect to improve quality of life and prognosis in ANOCA patients.

Read PDF

Similar papers

Aug 2026

Updates on Imaging Modalities for the Diagnosis of Aortic Stenosis.

Integration of echocardiography, computed tomography, CMR, and emerging positron emission tomography and artificial intelligence-based approaches can help address diagnostic uncertainty in aortic stenosis.

H. Itani, M. Moumneh, Ahmed A. Zayed et al. · 0 citations
Aug 2026

The DiagnOsis of MINOCA (DOMINO) registry: a real-world use of multimodality imaging and its impact on etiologic classification.

Advanced diagnostic testing was associated with a higher likelihood of a determined etiologic diagnosis in MINOCA, despite marked international variability in its use; however, this association is partly definitional, as advanced testing directly contributes to diagnostic ascertainment for several etiologic categories.

D. Morrone, M. Alberti, J. Cravo et al. · 0 citations
Sep 2026

Exercise stress echocardiography for diagnosis of heart failure with preserved ejection fraction: a multicentre study.

Addition of LA strain imaging with optimized rule-in or rule-out values improves diagnostic triage by expanding non-invasive rule-in/rule-out classifications while identifying patients who still require invasive testing in the evaluation of HFpEF.

T. Harada, Yogesh N. V. Reddy, H. Sorimachi et al. · 0 citations
Review Open access Sep 2026

From Guidelines to Ground Reality: The Underutilization of Stress Cardiac MRI in Ischemic Heart Disease - A Narrative State-of-the-Art Review.

Bridging the implementation gap for stress CMR will require coordinated efforts in education, infrastructure investment, policy reform, and targeted dissemination to ensure broader, equitable integration of this clinically valuable tool.

O. Abdelhai, Wael Aljaroudi, Musa A. Sharkawi et al. · 0 citations
Review Open access Sep 2026

Moderate aortic stenosis: diagnostic pitfalls and the role of multimodality imaging in risk stratification and clinical management

Moderate aortic stenosis (AS) has traditionally been considered a transitional and relatively benign stage of valvular disease. Yet, contemporary evidence shows that it is associated with substantial morbidity and mortality even before progression to severe AS. This paper synthesizes current evidence on the limitations...

G. Santangelo, A. Maloberti, C. Tognola et al. · 0 citations
Review Sep 2026

Carotid Web: A Practical Approach to Diagnosis, Risk Assessment, and Management

Evidence indicates that, in symptomatic patients, antithrombotic therapy alone is insufficient to prevent early recurrence, whereas carotid revascularization with endarterectomy or stenting provides excellent safety and efficacy.

Leonardo D. Cura-Rodríguez, G. Lanzino, L. Rangel-Castilla · 0 citations

We use cookies to run the site and, with your consent, for analytics and to show ads. See our Cookie Policy.