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Microvascular Ischemic Disease - Symptoms, Causes, Risk Factors, Diagnosis, Treatment, and Prevention

Published on Nov 05, 2019 and last reviewed on Jan 11, 2023   -  5 min read


Microvascular ischemic diseases are a group of diseases that affect the small blood vessels in the body. This article discuses its types, symptoms, causes, diagnosis, and treatment.

Microvascular Ischemic Disease - Symptoms, Causes, Risk Factors, Diagnosis, Treatment, and Prevention

What Is Microvascular Ischemic Disease?

The group of diseases that result from changes to the small blood vessels in the brain is known as microvascular ischemic disease or small vessel ischemic disease or cerebral small vessel disease. If it affects the small blood vessels of the heart, it is called coronary microvascular disease.

Such changes can damage the white matter of the brain, which contains nerve fibers that connects other parts of the brain. This condition is common in older adults, and if left untreated, it can lead to memory problems, balance problems, and stroke.

In the heart, this disease damages the walls of the small arteries, which results in signs and symptoms of heart disease like chest pain, dyspnea, etc.

The blood flow in the small blood vessels of other organs like kidneys, eyes, etc., can also get blocked and can lead to microvascular ischemic disease.

What Are the Signs and Symptoms of Microvascular Ischemic Disease?


Milder forms of this disease do not produce any signs or symptoms, even if they damage a small part of the heart or brain. This is the reason it is called “silent” disease. In severe cases, the following signs and symptoms are seen:


  • Cognitive impairment (loss of the ability to think).

  • Walking and balance issues.

  • Depression.

  • Weakness on one side of the body.

  • Confusion.

  • Speaking problems.

  • Loss of vision.

  • Dizziness.

  • Severe headache.


  • Chest pain.

  • Left-arm pain.

  • Jaw and neck pain.

  • Dyspnea (shortness of breath).

  • Lack of energy.

Get immediate medical help if you notice these symptoms, as it is a medical emergency.

What Causes Microvascular Ischemia?


The cause of microvascular ischemic disease is believed to be the result of atherosclerosis, which is caused by plaque buildup and hardening that damages the blood vessels. This narrowing of blood vessels can result in stroke and heart attacks.

This damage to the blood vessel can block blood flow and deprive the brain or heart cells of oxygen, or the blood vessels can break and bleed.

What Are the Risk Factors for Microvascular Ischemic Disease?

The factors that increase the risk of microvascular ischemic disease are:

  • Hypertension (high blood pressure).

  • High cholesterol.

  • Smoking.

  • Obesity.

  • Diabetes (high blood sugar).

  • Aging.

  • Atherosclerosis.

  • Atrial fibrillation.

  • Inactive lifestyle.

  • Unhealthy dietary habits.

  • Chronic inflammation.

  • Polycystic ovarian syndrome (PCOS).

What Are the Complications of Microvascular Ischemic Disease?

If left untreated, and if the blood flow is blocked or the blood vessel ruptures, severe complications can result. The common complications include:



How Is Microvascular Disease Diagnosed?

If you have symptoms that point towards microvascular ischemic disease, then your doctor will suggest you get the following tests:


  • MRI scan - This diagnostic test uses strong magnetic and radio waves to form a detailed image of your brain. Microvascular ischemic disease can appear as small strokes (lacunar infarcts) or white matter lesions (white matter hyperintensities) or bleeding from small blood vessels (cerebral microbleeds).


  • Treadmill test or Stress test - Your heart rate is monitored while you exercise on a treadmill or a bike.

  • Coronary angiogram - To check if the major heart arteries are blocked.

  • Positron emission tomography (PET) - It shows your heart's blood flow to other parts of the body.

  • CT and MRI scan - To obtain a detailed image of the heart and blood vessels.

  • Endothelial dysfunction test - This test is done if the doctor cannot find any abnormality in the major blood vessels. The blood flow in the small blood vessels is checked.

How Is Microvascular Ischemic Disease Treated?

Treatment is done to manage the risk factors that contribute to this condition. It includes:

  • Treating hypertension with the help of diet, exercise, and medication.

  • With diet, exercise, and medicines, the cholesterol level is reduced.

  • Taking medicine to lower homocysteine levels.

  • To use blood-thinning drugs to prevent strokes.

  • Quitting smoking.

The medications used are:

  • Nitroglycerin to ease chest pain.

  • Beta-blockers like Propranolol Bisoprolol to treat hypertension.

  • Angiotensin II receptor blockers (ARBs) such as Azilsartan help relax your blood vessels and lowers blood pressure.

  • Calcium channel blockers like Verapamil and Diltiazem to increase blood flow to the heart and control high blood pressure.

  • Ranolazine helps relieve chest pain by regulating the sodium and calcium levels.

  • Aspirin to prevent blood clots.

  • Statins like Atorvastatin and Simvastatin to lower cholesterol.

  • Angiotensin-converting enzyme (ACE) inhibitors like Benazepril and Lisinopril for hypertension.

What Are the Ways to Prevent Microvascular Ischemic Disease?

Some tips to prevent this condition are:

  • Avoid smoking and using other tobacco products.

  • Eat a healthy and balanced diet.

  • Exercise regularly.

  • Check your cholesterol levels at regular intervals.

  • Keep monitoring your blood pressure.

  • Maintain a healthy weight.

  • Prevent and manage all kinds of stress.

  • Keep your blood sugar level under control.

  • Limit the intake of alcohol.

Microvascular ischemic disease can lead to stroke, heart attack, dementia, and even death. It does not cause any symptoms in the early stages, so the best way to prevent these complications is by preventing damage to small blood vessels. Follow the above preventive measures, which will not only prevent this disease but most of the chronic and life-threatening diseases. For more information on this condition, consult a doctor online.


Last reviewed at:
11 Jan 2023  -  5 min read




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