|
|
|
Key Points
- Coronary microvascular disease (MVD) affects the
heart's smallest coronary arteries. Coronary MVD occurs when plaque forms in
the arteries, when the arteries spasm (tighten), or when the walls of the
arteries are diseased or damaged.
- In coronary MVD, plaque can scatter, spread out
evenly, or build up into blockages in the small coronary arteries. Plaque
reduces the flow of oxygen-rich blood to the heart muscle. Spasms also prevent
enough oxygen-rich blood from getting to the heart muscle. Changes in the
arteries' cells and the surrounding muscle tissues may, over time, damage the
arteries' walls.
- In coronary MVD, plaque doesn't always lead to
blockages as it does in traditional
coronary
artery disease (CAD). For this reason, coronary MVD is called
nonobstructive CAD.
- Coronary MVD is a new concept. It's currently
being studied as a possible cause of heart disease in women. Many researchers
think that a drop in estrogen levels in women at menopause combined with risk
factors for heart disease causes coronary MVD.
- No one knows whether coronary MVD is the same as
MVD linked to other diseases, such as
diabetes.
- The same cluster of risk factors that cause
atherosclerosis
and CAD may cause coronary MVD. These include
unhealthy
cholesterol levels,
high
blood pressure, smoking, insulin resistance, diabetes,
overweight
and obesity, lack of physical activity, age, and family history of early
heart disease.
- Coronary MVD in women may be linked to low
estrogen levels occurring before or after menopause. It also may be linked to
anemia
or conditions that affect blood clotting.
- Signs and symptoms of coronary MVD often differ
from those of traditional CAD. Typical signs and symptoms of CAD include
angina
(chest pain), feeling pressure or squeezing in the chest, shortness of breath,
excessive sweating, and arm or shoulder pain. Many women with coronary MVD have
angina, but it may not by "typical."
- Women with coronary MVD may also have shortness
of breath, sleep problems, fatigue (tiredness), and lack of energy. In women,
symptoms are often first noticed during routine daily activities and times of
mental stress.
- Medical history and a physical exam are used to
diagnose coronary MVD. Your doctor may also give you tests for traditional CAD.
These may include
coronary
angiography,
stress
testing, and magnetic resonance imaging cardiac stress testing. You also
may be asked to fill out a questionnaire called the Duke Activity Status Index,
which measures how well you're able to do your daily activities.
- If test results show you don't have traditional
CAD, you can still be diagnosed with coronary MVD if evidence shows that not
enough oxygen is reaching the small arteries in your heart.
- Women who have coronary MVD are treated with
medicines to control symptoms and risk factors for heart disease. Women
diagnosed with coronary MVD who have anemia may benefit from treatment for that
condition.
- Women who are diagnosed and treated for coronary
MVD should be checked regularly by their doctors.
- No specific studies have yet been done on how to
prevent coronary MVD. It's not yet known how or in what way preventing coronary
MVD differs from preventing CAD. People can take steps to delay or prevent CAD
by making lifestyle changes, taking medicines, and getting regular medical
care.
- If you have coronary MVD, you can take steps to
stop it from getting worse. These may include lifestyle changes, medicines, and
regular medical care.
- If you have symptoms of heart disease, know how
and when to seek medical help. Be able to describe your symptoms, and know how
to control them. Know which medicines you take and how to take them. Finally,
know the limits of your physical activity and how to avoid or cope with stress.
- If you have signs and symptoms of a
heart
attack, such as chest pain, upper body discomfort, shortness of breath, and
nausea, call 911 right away.
|
|
Living With
Links
|