Aim:
The prevalence of ischemia with nonobstructive coronary artery disease increases all over the world which is confirmed by the results of angiographies. However, physicians diagnose only the tip of the iceberg. The latter is predominantly connected with several factors, namely atypical nonspecific silent manifestation, the course of the disease, the high cost of the investigational procedures for the diagnosis establishment, and low awareness of medical specialists regarding abovementioned nosology. In the current paper, we aimed to propose the algorithm of early atherosclerosis diagnostic with combination of anatomical and functional methods of patient's condition assessment.

Material and methods:
questinearing, physical examination, laboratory analysis, modified stress test which consists of electrocardiography, echocardiography, laser Doppler flowmetry, pulse oxymetry, capnometry, lactate measurement, and blood pressure monitoring while cycling, coronary computed tomography angiography.

Case report:
This clinical report demonstrates the case of nonobstructive coronary artery disease in a 38-year-old male with the only complaint of an episodical increase in blood pressure. A combination of risk factors raised the suspicion of nonobstructive coronary artery disease. It was substantiated by the modified stress test which consists of electrocardiography, echocardiography, laser Doppler flowmetry, pulse oxymetry, capnometry, lactate measurement, and blood pressure monitoring while cycling. Only afterward, the patient passed over coronary computed tomography angiography, which confirmed the suspected diagnosis precisely.

Summary:
Based on the current case, we aimed to increase the awareness of physicians about nonobstructive coronary artery disease and propose an algorithm for nonobstructive coronary atherosclerosis screening.