Symptoms of Microvascular Disease
Coronary microvascular dysfunction is a problem with the small arteries of the heart that branch off of the main arteries. Damaged arteries can lead to constriction or spasm. Patients often experience chest pain or pressure, or shortness of breath. Some patients my experience heart attack or a heart muscle impairment as a result.
A diagnosis of coronary microvascular dysfunction is important because the coronary microvasculature accounts for 90 percent of the coronary blood flow. Thirty percent of patients who experience ischemic-sounding chest pain and have abnormal non-invasive testing go on to have normal angiograms. Historically, these patients were reassured and not started on any medical therapy.
There should be a high suspicion of coronary microvascular dysfunction in patients who have ischemic-sounding chest pain and normal angiograms. Angiograms only visualize the main arteries of the heart. Gold standard for diagnosing coronary microvascular dysfunction is through an invasive physiology study. Special medications are infused during the physiology study to measure the coronary blood flow and resistance down the heart arteries.
Depending on your resistance and coronary blood flow, this can lead us to a diagnosis of coronary microvascular dysfunction. There are many classes of medications that help to improve the heart function. ACE inhibitors, beta blockers and statins are some of the main choices. There are other medications that may be prescribed to you depending on the results of your physiology study.
The most important thing you can do to improve your heart artery function is exercise and stress reduction. If you are a smoker, stopping smoking is the best thing you can do for your heart arteries. It’s not uncommon for patients with suspected coronary microvascular dysfunction to experience anxiety and depression surrounding their condition. If you’re feeling anxious or depressed about your diagnosis of coronary microvascular dysfunction, please talk to your family physician or other healthcare provider for more advice. Other great tips for patients with coronary microvascular dysfunction include yoga or meditation for stress reduction. Cardiology
Presenter: Mary McCarthy, Nurse, Newmarket, ON