Cardiology: microvascular angina: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: microvascular angina

Sample item

A 48-year-old woman has exertional chest pain relieved by rest. Treadmill testing shows ST depression, but coronary angiography shows smooth, normal epicardial arteries. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Coronary microvascular dysfunction

Typical angina with a positive stress test and normal epicardial arteries is called cardiac syndrome X or microvascular angina. It reflects impaired small-vessel vasodilation. Beta blockers, calcium channel blockers and risk factor control are used.

Option by option

  • A. Coronary microvascular dysfunction (correct)

    Correct. Angina with normal angiography reflects dysfunction of the small coronary vessels.

  • B. Aortic dissection

    Dissection gives sudden tearing pain and is not reproducibly exertional.

  • C. Left main coronary stenosis

    Left main stenosis would be seen on angiography.

  • D. Acute pericarditis

    Pericarditis gives pleuritic, positional pain with diffuse ST elevation, not exertional pain.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Coronary microvascular dysfunction. Typical angina with a positive stress test and normal epicardial arteries is called cardiac syndrome X or microvascular angina.

Why is "Aortic dissection" not the answer?

Dissection gives sudden tearing pain and is not reproducibly exertional.

Why is "Left main coronary stenosis" not the answer?

Left main stenosis would be seen on angiography.

Why is "Acute pericarditis" not the answer?

Pericarditis gives pleuritic, positional pain with diffuse ST elevation, not exertional pain.

What concept does this question test?

It tests Cardiology: microvascular angina in General Medicine. It reflects impaired small-vessel vasodilation. Beta blockers, calcium channel blockers and risk factor control are used.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: microvascular angina?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.