Pieter A. Doevendans,Yolande Appelman, Cardiac Microvascular Disease - A Complex Diagnosis? Heart and Circulatory System 2020 http://dx.doi.org/10.31487/j.HCS.2020.01.03 https://www.sciencerepository.org/cardiac-microvascular-disease_HCS-2020-1-103 Abstract: Diagnosing microvascular disease in a continuously moving organ like the contracting heart is difficult. Although we have a wide ranch of (non)invasive diagnostic tools available it is still a challenge to reach a solid conclusion. In many patients there is also a combination of risk factors inducing several disease causing mechanisms further obscuring classification strategies. More research will be crucial going form histology to function to determine the position of microvascular disease in patients with unexplained chest pain.Keywords: Microvascular disease, coronary spasm, coronary artery disease