Pathogenetic mechanisms of coronary microvascular dysfunction
| Alterations | Causes |
| Structural | |
| Luminal obstruction | Microembolisation in acute coronary syndromes or after recanalisation |
| Vascular wall infiltration | Infiltrative heart disease (eg, Anderson–Fabry cardiomyopathy) |
| Vascular remodelling | Hypertrophic cardiomyopathy, arterial hypertension |
| Vascular rarefaction | Aortic stenosis, arterial hypertension |
| Perivascular fibrosis | Aortic stenosis, arterial hypertension |
| Functional | |
| Endothelial dysfunction | Smoking, hyperlipidaemia, diabetes |
| Dysfunction of smooth muscle cell | Hypertrophic cardiomyopathy, arterial hypertension |
| Autonomic dysfunction | Coronary recanalisation |
| Extravascular | |
| Extramural compression | Aortic stenosis, hypertrophic cardiomyopathy, arterial hypertension |
| Reduction in diastolic perfusion time | Aortic stenosis |
Reproduced with permission from: Camici PG, Crea F. Coronary microvascular dysfunction. N Engl J Med 2007;356:830–40. Copyright (2007) Massachusetts Medical Society. All rights reserved.