Introduction
Coronary microvascular disease is a cardiac condition resulting when the small arterial walls in the heart do not work correctly. This will reduce the flow of oxygen-rich blood to the heart, which causes chest pain, breathing difficulty, and other symptoms of heart disease. There is clogging and narrowing of arteries that supply blood to the heart. It can occur in coronary arteries, the heart’s largest arteries, and smaller blood vessels. Small vessel disease can also be called coronary microvascular disease and microvascular endothelial dysfunction. Small vessel diseases are challenging to detect but can be treated. The diagnosis is made after the healthcare provider finds little or no narrowing in the heart's main arteries, even though symptoms suggest heart disease.
What Is Coronary Microvascular Disease?
Coronary microvascular disease is a cardiac disease affecting the inner lining and the walls of tiny coronary artery blood vessels that will branch from larger coronary arteries. Coronary heart disease might cause the formation of plaque that will block the blood flow to the heart muscle. In coronary microvascular disease, there is no plaque in the heart's coronary artery blood vessels, but the inner walls of the blood vessels can be damaged, which can further lead to spasms and decreased blood flow to the heart. Coronary microvascular disease can also be due to abnormalities in small arteries that branch off the main coronary arteries. Younger women more frequently develop coronary microvascular disease, and risk factors are similar to coronary artery disease, such as high blood pressure, diabetes, and high cholesterol.
What Is the Role of Coronary Microvasculature?
The coronary microvasculature in the heart is a network of tiny blood vessels, most of which are the size of human hair. Within the heart, these vessels control blood flow and capillary exchange. Capillary exchange is one of the complex processes where oxygen-rich blood is supplied by the vessels and oxygen-poor blood from nearby tissue.
What Is the Difference Between Coronary Microvascular Disease and Coronary Artery Disease?
There is a risk of heart attack with both these conditions. Coronary artery disease impacts larger vessels known as coronary arteries that overlay the heart, and this condition mostly occurs when fatty deposits inside the arteries reduce or block blood flow completely. Coronary microvascular disease will affect the microvasculature and prevent the blood from nourishing the heart tissue. It occurs when there is damage to the blood vessels or malfunction of the small blood vessels and no plaque build-up.
What Is the Risk Factor of Coronary Microvascular Disease?
This disease is more common in women than men and especially in individuals with low estrogen levels, which occurs after menopause. The risk factors are:
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Obesity or overweight.
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Diabetes.
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Autoimmune disease, including vasculitis.
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High cholesterol.
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High blood pressure.
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Intake of high amounts of salt, saturated fat, and processed foods.
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Lupus or rheumatoid arthritis are rheumatological disorders.
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Smoking.
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Sedentary lifestyle patterns as there are reduced levels of physical activity.
What Causes Coronary Microvascular Disease?
This condition will affect the smooth muscle function of the heart's small arteries. In a healthy heart, these muscles narrow and widen to keep up with the heart’s changing needs. With coronary microvascular disease, the inner walls of the small vessels get damaged, and spasms can occur due to this damage that disrupts the blood flow to the heart.
What Are the Symptoms of Coronary Microvascular Disease?
The type of chest pain known as angina is the primary symptom that lasts for ten minutes or longer, even when resting. With mental stress, there can be an increase in pain, which is often less with physical exertion. The symptoms of microvascular disease make it challenging to go about daily life. Symptoms of coronary microvascular disease are:
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Shortness of breath.
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Fatigue.
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Sleeping issues, including insomnia.
Chest pain can also be a symptom of a heart attack, where there can be breathing difficulty or pain that runs down the back, neck, or arms.
How Is Coronary Microvascular Disease Diagnosed?
As the microvessels are too small to assess using standard heart tests, it is very challenging to diagnose coronary microvascular disease. To receive an accurate diagnosis and timely care, it is advised to consult a cardiologist who specializes in small vessel disease. The gold standard for diagnosis of coronary microvascular disease is cardiac catheterization with coronary flow reserve. This sophisticated test will measure the microvessels' ability to quickly expand and deliver more blood depending upon the body’s need. The other tests to measure coronary microvascular disease are nuclear cardiac stress test (PET) scan and cardiac magnetic resonance imaging with perfusion.
How Is Coronary Microvascular Disease Treated?
Coronary microvascular disease is often treated with the help of medicines in order to help the blood vessels work more effectively and lower the risk of complications. The treatment options are:
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Statins.
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Calcium channel blockers.
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Beta-blockers.
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Anticoagulants.
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Angiotensin-converting enzyme (ACE) inhibitors.
How Can Coronary Microvascular Disease Be Prevented?
It is essential to take good care of the heart and lower the risk of complications. This includes:
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By being more active physically, they can benefit from cardiac rehabilitation.
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Blood pressure should be maintained within the range.
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Consuming a heart-healthy diet.
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Quitting smoking.
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High blood sugar should be reduced.
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By maintaining a healthy weight.
Conclusion
Coronary microvascular disease occurs when there is damage to tiny blood vessels that help to regulate the blood flow to the heart tissue. This condition is complex to detect but can be treated with the help of medicines that will help the blood vessels work more effectively and lower the risk of complications.
