Small vessel disease

Overview 

The heart’s small arteries can develop small vessel disease when their walls don’t function properly. This decreases the amount of oxygen–rich blood reaching the heart, which results in angina, shortness of breath, and other heart disease symptoms. Small vessel disease is often referred to as microvascular endothelial dysfunction or coronary microvascular disease. Other names for small vessel disease are small artery disease, cardiac X syndrome, microvessel disease, or nonobstructive coronary heart disease.  

Small vessel disease, although challenging to detect, is a treatable condition. Typically, healthcare providers diagnose this condition when symptoms indicative of heart disease are present, yet they find minimal or no narrowing in the main arteries of the heart. This condition tends to affect women, individuals with diabetes, and those with high blood pressure more frequently. 

Symptoms 

Signs and symptoms of small vessel disease include: 

• Angina, which is chest pain, pressure, or discomfort that may get worse with activity or emotional stress 
• Chest pain accompanied by discomfort in the left arm, jaw, neck, back, or abdomen 
• Difficulty of breathing 
• Fatigue and less energy 

Persistent symptoms after receiving angioplasty and stents to treat coronary artery disease may indicate the presence of small vessel disease. If you have chest pain accompanied by other symptoms such as shortness of breath, sweating, nausea, dizziness, or discomfort in your arms, neck, or jaw, it is essential to seek immediate medical attention. 

However, if you don’t experience chest pain, it may be challenging to determine the cause of your symptoms, and consulting your doctor is recommended. If you suddenly experience unexplained chest discomfort or suspect a heart attack, do not hesitate to call for emergency medical assistance. 

Causes 

Coronary small vessel disease occurs when the tiny arteries in the heart fail to relax or dilate correctly, leading to inadequate oxygen–rich blood supply to the heart. Experts suggest that small vessel disease shares the same underlying causes as disorders affecting the larger vessels of the heart, such as obesity, diabetes, high blood pressure, and high cholesterol. 

Risk factors 

Women experience small vessel disease more frequently than do males. Small vessel disease risk factors include: 

• Diabetes 
• Increased blood pressure 
• Being overweight or obese 
• Abnormal cholesterol level 
• Eating unhealthy food such as salty foods and processed foods. 
• Sedentary living 
• History of the disease in the family, particularly in women 
• Men must be older than 45, while women must be older than 55. 
• Having rheumatologic disease including rheumatoid arthritis or lupus. 
• Having autoimmune disease such as vasculitis.  
• Polycystic Ovary Syndrome(PCOS) 
• Smoking or using tobacco