The small blood vessels in the heart, called the coronary microvasculature, carry most of the blood flow to the heart muscle, delivering oxygen. These blood vessels can become unhealthy when there is damage to their inner lining. There can also be plaque buildup in the larger coronary arteries that does not narrow them but can contribute to abnormal blood flow.  

 Over time, this leads to abnormal widening or narrowing of the small vessels in response to exercise or stress, which can cause problems with the blood supply to the heart, causing chest pain, shortness of breath, heart attack, and heart failure. 

In this interview, C. Noel Bairey Merz MD, FACC, FAHA, FESC, and Purvi Parwani MBBS, MPH, FACC, discuss Management of INOCA and MINOCA: What Do We Know and How Are We Doing? 

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