Inclusion Criteria:

• ≥ 18 years of age.
• Ability to give informed consent.
• Structurally normal heart (normal LV and RV function, no more than mild valvular heart disease).

For Controls:

• typical chest pain with indication for CMD testing.

For T2MI:

• Meet criteria for T2MI according to the 4th Universal definition of MI (rise/fall of troponin with at least 1 value > 99th centile+ evidence of symptoms or signs of myocardial ischemia).

Exclusion Criteria:

• Acute coronary event (evidence of plaque rupture, fissure or dissection on coronary angiogram).
• Known to have angiographically significant CAD/pressure wire positive for epicardial CAD.
• Hb<8 within 1 week of study enrollment.
• Inability to receive heparin products.
• Allergy/contraindication to acetylcholine/adenosine/nitroglycerine products.
• Prior coronary artery bypass grafting.
• Pregnancy (if sexually active woman of reproductive age, need negative pregnancy test prior to proceeding with coronary angiography – this is standard of care in cath lab).
• Asthma with prior ICU admission due to bronchospasm/need for invasive ventilation.

Note: Other protocol defined Inclusion/Exclusion Criteria may apply.

Eligibility last updated 12/5/22. Questions regarding updates should be directed to the study team contact.