Pathophysiology, diagnosis, and current management strategies for chest pains in patients with normal findings on angiography

Chest pain syndromes in patients with normal angiographic findings represen t a multifactorial pathophysiologic state, which may range from abnormaliti es in pain perception to abnormalities in endothelial- and non-endothelial- dependent coronary flow reserve associated with myocardial ischemia. Treatm ent begins with an accurate diagnosis by obtaining a comprehensive history and performing a physical examination, followed possibly by performing func tional angiography in those who continue to have symptoms. This approach ma y help to determine appropriate treatment.