Targeted Therapies for Microvascular Disease

CMD remains a challenging condition to manage due to heterogenous pathophysiology, presentation, and response to therapy. Awareness of CMD is improving but therapeutic randomized trials of therapy are lacking. Invasive assessment of the coronary microcirculation can stratify antiischemic therapy to improved patient-centered outcomes. Beta-blockers remain the cornerstone of therapy for angina due to CMD. The role of non pharmacological interventions including cardiovascular risk factor modification, lifestyle interventions, and cardiac rehabilitation is central to management. Further research is needed to assess traditional and novel pharmacological therapies on symptoms and clinical events in the various CMD endotypes.