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We discuss diagnostic approaches, including invasive and non-invasive techniques, such as PET, cardiac MRI and intracoronary physiological testing. Current management strategies focus on risk factor modification and tailored pharmacotherapy, with emerging therapies targeting endothelin pathways. A comprehensive understanding of CMD is essential for improving diagnostic accuracy and developing effective treatments for patients presenting with ischaemic symptoms absent of angiographic evidence of coronary obstruction.<\/jats:p>","DOI":"10.15420\/ecr.2025.30","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T11:42:53Z","timestamp":1762947773000},"source":"Crossref","is-referenced-by-count":2,"title":["The Coronary Microcirculation Re-explored: Pathophysiological Insights and Clinical Implications"],"prefix":"10.15420","volume":"20","member":"6096","published-online":{"date-parts":[[2025,11,8]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Padro T, Manfrini O, Bugiardini R, et al. 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