CC-BY-NC-ND 4.0 · Ind J Car Dis Wom 2017; 02(03): 049-053
DOI: 10.1055/s-0037-1606856
Case Report
Women in Cardiology and Related Sciences

Refractory Chest Pain or Treating Cardiologist's Bane: A Case Report

Anupama V. Hegde1, Abhinay Tibdewal1, Vadagenalli S. Prakash1, Sarthak Sahoo1
  • 1Department of Cardiology, M. S. Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India
Further Information

Publication History

Publication Date:
01 December 2017 (online)


Microvascular angina is caused by dysfunction of small-resistance coronary arteries (< 500 µm) and is of heterogenous origin. The major epicardial coronaries are normal and commonly seen in women. Prognosis is variable, with disabling angina in many patients and can be a cause of mortality, especially in those who are refractory to treatment. In this background, we present a case of 56-year-old post valve replacement with normally functioning aortic valve and recurrent episodes of microvascular angina. The patient had normal epicardial coronaries. She had recurrent episodes of angina refractory to various antianginals associated with hemodynamic instability. Microvascular angina can curtail routine activity, frequent hospitalization, and repeated noninvasive and invasive investigations. Thus, it is a high social and economical disease, especially pertinent to women.