When we think of cardiovascular disease, the mind often goes straight to dramatic events like heart attacks.
Most of us know that hardened, clogged arteries can cause heart problems, but even the tiny blood vessels in the heart can play a role in increasing your risk of a heart attack.
Coronary microvascular disease (CMD) is a condition where abnormalities in these tiny blood vessels reduce the flow of blood to the heart muscle. The abnormalities can be caused by different things, including chronic inflammation, abnormal narrowing of blood vessels, or dysfunctional inner lining of the vessels.
“When the inner walls of these tiny vessels are damaged, it can trigger a spasm that disrupts blood flow to your heart,” said Robert Pearce, MD, a cardiologist with Endeavor Health. “This causes symptoms that can feel similar to a heart attack.”
The main symptom of coronary microvascular disease is chest pain that feels like squeezing and/or pressure and lasts more than 10 minutes, even up to 20 minutes. Other symptoms include:
- Shortness of breath
- Fatigue
- Pain in the neck, jaw, throat, back or arms
- Heart palpitations
“If you’re feeling symptoms like these or think you might be having a heart attack, it’s important to call 911 and get evaluated immediately,” Dr. Pearce said. “Be sure to give your primary care doctor your full family history, share your lifestyle habits, and get regular blood pressure, cholesterol and diabetes screenings, as these details can provide clues that help your doctor gauge your risk for coronary microvascular disease and other conditions.”
CMD is more common in women, specifically menopausal women. Risk factors also include:
- High blood pressure
- Family history of autoimmune conditions, early heart disease, diabetes, high blood pressure or chronic kidney disease
- Smoking
- Diabetes
- Being overweight or obese
- A sedentary lifestyle
- High cholesterol
The tests to diagnose coronary microvascular disease are similar to the tests used to diagnose traditional heart disease, including angiograms, stress tests and MRIs. Treatment is often handled with medication.
There are things you can do to lower your risk of CMD, and heart disease overall, including keeping blood pressure, blood sugar and cholesterol at healthy levels, maintaining a healthy weight, staying active and exercising, and if you smoke, quitting smoking.
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