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Coronary microvascular disease (MVD), or small artery disease, affects the tiny coronary blood vessels that branch off from larger coronary arteries and supply blood flow to the heart.
In coronary MVD, the walls and inner lining of the smaller blood vessels are damaged, which can lead to spasms and decreased blood flow to the heart. This disease is different from coronary artery disease, in which plaque buildup blocks blood flow to the heart.
Typically, coronary microvascular disease affects women, especially younger women, more than men, according to the American Heart Association (AHA).
Since coronary MVD affects the tiny coronary arteries, not the major coronary arteries, it is more challenging to diagnose. Small artery disease is often found when a doctor finds little or no narrowing of the main arteries despite ongoing symptoms of heart disease, such as chest pain. Your doctor may rely on a PET scan or other types of imaging to diagnose small artery disease.
A common symptom of coronary MVD is chest pain (or angina). Other symptoms include shortness of breath, sleep problems, fatigue and lack of energy. You may also experience discomfort in one or both arms, neck, jaw, back or abdomen. Other possible signs include shortness of breath, breaking out in a cold sweat, nausea or lightheadedness.
You may first notice symptoms of coronary MVD during routine daily activities or during times of stress. This differs from disease of the major coronary arteries, in which symptoms usually first appear during physical activity or exertion.
Research suggests some of the risk factors that cause atherosclerosis, a disease in which plaque builds up inside the arteries, may also lead to coronary MVD. Risk factors for coronary MVD include:
The AHA notes that the role of hormones in heart disease is being researched to find better ways to diagnose coronary MVD. The AHA also notes that women who have had lower than normal estrogen levels in their lifetime may be at risk for developing the disease. It also notes that women who have had high blood pressure, especially a high systolic blood pressure, before menopause and women who have intense symptoms during menopause, may be more likely to develop heart issues.
Untreated coronary MVD restricts blood flow to the heart, which over time can lead to irreversible heart damage. One primary goal of coronary MVD treatment is to relieve pain. Treatment is also used to control risk factors and symptoms, and may include medications to improve cholesterol, lower blood pressure, prevent blood clots and relax blood vessels.
To help lower your risk for heart disease, including coronary MVD, consider:
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