Coronary microvascular dysfunction (CMD) is an underappreciated cause of angina and yet associated with worse quality of life and adverse outcomes. The index of microcirculatory resistance (IMR) has been the gold standard for coronary microvascular assessment which utilizes a thermistor tipped pressure-wise based system and assesses microvasculature during maximal hyperemia. Recently, an angiography-based method for the assessment of CMD, IMRangio, has emerged as an attractive alternative to the IMR [ , ]. We present two patients who were referred to our cardiac catheterization laboratory due to angina and underwent additional physiologic assessment of CMD utilizing both traditional IMR and IMRangio.