Potential Role of 13N-NH3 Cardiac PET in Monitoring Treatment Response in Patients with Microvascular Angina

Ischemia with nonobstructive coronary artery disease (INOCA) refers to patients who present with signs and symptoms of myocardial ischemia despite the absence of obstructive coronary artery disease. Coronary microvascular dysfunction (CMD) is one of the underlying causes of INOCA and is associated with an increased risk of major adverse cardiac events. CMD is often detected as impaired coronary flow reserve (CFR) during invasive coronary angiography. We hereby report a patient with microvascular angina (MVA), having impaired myocardial flow reserve and perfusion defects at cardiac positron emission tomography (PET) imaging. The patient demonstrated improved myocardial perfusion and dynamic PET parameters following medical management.