Angina pectoris with coronary microvascular dysfunction

This code signifies chest pain or discomfort due to myocardial ischemia, specifically attributed to impaired function of the small coronary blood vessels rather than epicardial coronary artery obstruction. It represents a form of angina where the microcirculation is the primary source of reduced blood flow to the heart muscle.

Apply this code when documentation explicitly states angina pectoris and identifies coronary microvascular dysfunction (CMD) as the underlying cause. This diagnosis is often made after ruling out obstructive coronary artery disease through angiography, and may be supported by findings from cardiac MRI, PET scans, or stress testing showing microvascular abnormalities.

• Ensure documentation clearly distinguishes CMD from obstructive coronary artery disease.
• Do not use this code for angina due to epicardial coronary artery stenosis; use appropriate I20.x codes instead.
• Look for terms like "cardiac syndrome X," "non-obstructive coronary artery disease with microvascular dysfunction," or "microvascular angina."