Unlike coronary artery disease, in which sporadic accumulations of atherosclerotic plaque may extend into the center of the vessel, microvascular disease is characterized by plaque deposited uniformly around the inside of the smaller vessels forming networks that feed into the coronary arteries. The vessels become stiffer and don’t expand well in response to the demands of exercise or other stresses.
It is more common in women, particularly those who have cardiovascular risk factors or diabetes. And it is likely to be the cause of chest pain and other symptoms of heart disease in women who don’t have coronary artery obstructions.
How Microvascular Disease Develops
Researchers have found that the risk factors for microvascular disease are the same as for coronary atherosclerosis, including:
- Unfavorable cholesterol profile, particularly high LDL cholesterol, low HDL cholesterol and high triglycerides.
- High blood pressure, especially in premenopausal women.
- High blood sugar.
- Arthritis and other inflammatory and autoimmune disorders.
- Polycystic ovarian syndrome.
As inflammation wears away the lining of the vessels, cholesterol-filled plaque is deposited in its place, creating a stiff, inflexible wall. When the body’s demand for oxygen is increased by stress or exercise, the vessels can’t expand to increase the blood supply to the coronary arteries. As a result, the heart muscle doesn’t get the oxygen it needs to meet the challenge. Over time, the risk of heart failure increases.
Symptoms of Microvascular Disease
Although they can be confused with the flu, symptoms such as overall discomfort, shortness of breath and depression can signal that your heart isn’t getting enough oxygen. They may also be warnings of an impending heart attack.
Diagnosing Microvascular Disease
If a stress test, or exercise ECG, indicates an abnormality, your doctor may recommend a cardiac catheterization, including coronary angiography. If your doctors don’t see a coronary artery obstruction, they will perform reserve flow studies during the same procedure. Flow reserve studies don’t give a direct view of the tiny vessels; instead, they measure the pressure of blood flowing into the coronary arteries. Microvascular disease is diagnosed when the tiny vessels that feed into the coronary arteries are narrowed or do not dilate enough to provide an adequate blood supply to the heart.
Treating Microvascular Disease
Unlike coronary atherosclerosis, which results in distinct lesions, microvascular disease is a diffuse condition that can’t be treated with surgery or angioplasty. Instead, therapy is aimed at reducing the underlying conditions that contribute to it.
Nutrition and Prevention
Reference these links for information on how to prevent heart disease and how to live a healthy lifestyle.
- Lifestyle Changes
- Healthy Diet
- Reduce Stress
- Stop Smoking
- Healthy Cholesterol Levels
- Reduce Sodium
Date Last Modified: January 21, 2011
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