Ischemia with no obstructive coronary artery disease (INOCA) is not an uncommon diagnosis in patients presenting with chest pain who undergo clinically indicated coronary angiography. However, the symptoms reported by patients with INOCA may be heterogeneous, leading to misdiagnosis and undertreatment. Herein we report 3 clinical cases of INOCA misdiagnosis and describe how the cases were reinvestigated following the appropriate diagnostic pathway. ( Level of Difficulty: Advanced. ).
Competing Interests: Dr Ghizzoni has received a grant from Italian MoH within INOCA-IT Multicenter Registry RF-2019-12369486. Dr Chieffo has received speaker and/or consultation fees from Abiomed, Boston Scientific, Biosensor, Menarini, Medtronic, and Shock Wave Medical. Dr Montorfano has received consultant fees from Abbott, Boston, Kardia, and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(© 2023 The Authors.)