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:

• Diabetes
• High blood pressure
• High cholesterol
• Obesity (body mass index over 30)
• Inactive lifestyle
• Tobacco use
• Unhealthy diet
• Older age (men older than 45 and women older than 55)
• Chronic inflammation
• Estrogen deficiency
• Polycystic ovarian syndrome
• Family history of heart disease

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:

• Managing your health conditions. Certain health conditions, such as diabetes or high blood pressure, can increase your risk for heart disease. If diet and exercise don’t help keep those conditions under control, consult with a physician to see if medication will help. Be sure to take medications as directed and keep your doctor informed if there are any changes to your health.

• Knowing your numbers. Getting your blood pressure and cholesterol checked regularly can help identify problems early. Keep your blood sugars in check, too.
  
  
• Getting active. The AHA recommends 150 minutes of exercise per week. Sign up for a class at your local gym, go for walks with a friend or hit the bike trails. Regular exercise not only helps lower your risk for heart disease but improves overall health. If you don’t exercise, start. It may take a while to get into a regular routine, but starting with 10 minutes a day is better than doing nothing.
  
  
• Giving up cigarettes. Smoking is a major cause for heart disease according to the CDC. Quitting smoking has many health benefits, including greatly reducing your risk for heart disease.
  
  
• Maintaining a healthy weight. Obesity is a risk factor for heart disease. Keeping your weight in a healthy range will help lower your risk for heart disease. If you are overweight, consider talking to your physician about weight loss options.
  
  
• Adopting a heart-healthy diet. Be sure to eat a nutrient-rich diet that includes plenty of fruits and vegetables, skinless poultry and fish, whole grains and low-fat dairy. Limit your intake of sugary treats and beverages, saturated and trans fats, red meat and foods that are high in salt. Try some of these heart-healthy recipes.

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