Review
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. May 26, 2025; 17(5): 106541
Published online May 26, 2025. doi: 10.4330/wjc.v17.i5.106541
Myocardial ischemia in nonobstructive coronary arteries: A review of diagnostic dilemmas, current perspectives, and emerging therapeutic innovations
Hariharan Seshadri, Dhaiyanitha Gunasekaran, Abdulkader Mohammad, Srinivas Rachoori, Hamrish Kumar Rajakumar
Hariharan Seshadri, Institute of Internal Medicine, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai 600003, Tamil Nadu, India
Dhaiyanitha Gunasekaran, Srinivas Rachoori, Hamrish Kumar Rajakumar, Department of General Surgery, Government Medical College, Omandurar Government Estate, Chennai 600002, Tamil Nadu, India
Abdulkader Mohammad, Department of Medicine, University of Novi Sad, Novi Sad 21000, Serbia
Author contributions: Rajakumar HK contributed to writing - reviewing and editing and supervision of the work; Seshadri H, Gunaserkaran D, Mohammad A, Rachoori S, and Rajakumar HK were responsible for data curation, investigation, resources, and conceptualization; Seshadri H, Gunaserkaran D, Mohammad A, and Rajakumar HK wrote the original draft; Gunaserkaran D and Rajakumar HK handled visualization.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hamrish Kumar Rajakumar, Senior Researcher, Department of General Surgery, Government Medical College, Omandurar Government Estate, No. 169 Wallahjah Road, Police Quarters, Chennai 600002, Tamil Nadu, India. hamrishkumar2003@gmail.com
Received: March 3, 2025
Revised: March 27, 2025
Accepted: May 7, 2025
Published online: May 26, 2025
Processing time: 84 Days and 3.3 Hours
Core Tip

Core Tip: Myocardial infarction with nonobstructive coronary arteries is difficult to diagnose, and strong clinical suspicion is necessary for accurate identification. The absence of standardized diagnostic protocols leads to inconsistencies in patient evaluation and management. Current diagnostic tools, including imaging and laboratory tests, often fail to provide definitive answers. The identification of easily accessible biomarkers could improve early detection and guide clinical decisions. Reliable markers would help differentiate myocardial infarction with nonobstructive coronary arteries from other cardiac conditions and streamline diagnosis. The lack of standardized guidelines complicates treatment, making management challenging. Further research is essential to establish evidence-based protocols.