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Microvascular Angina (MVA) is a type of angina caused when the small blood vessels of the heart (micro vessels) do not work properly. The micro vessels are important as they supply most of the blood to the whole of the heart muscle. In Microvascular angina, these microvessels either fail to dilate, stay relaxed or constrict in temporary spasms. This is also known as Coronary Microvascular Dysfunction (CMD/CMVD) or now more commonly, Microvascular Dysfunction (MVD).
In the past, before it was better understood, Microvascular Dysfunction was seen as ongoing chest pain without obstructed coronary arteries and was called Cardiac Syndrome X (CSX). This term is sometimes still used to describe chest pain of unknown origin. It was thought that CSX was more of a problem associated with a person’s perception of pain rather than due to angina, along with a belief that MVA was a harmless benign condition.
In more recent times, there have been developments in the design of tests that can now more accurately diagnose MVA. There is growing evidence that now shows that MVA does increase an individual’s risk of experiencing heart and circulatory problems. This includes heart attacks, heart failure, arrhythmias, stroke and repeated hospital admissions as well as having a negative impact on the quality of life of those who live with MVA.
Learn all about the symptoms, causes and triggers of microvascular angina.
The symptoms of MVA are very similar to those experiencing vasospastic angina.
However, there a few symptoms that can be more prominent in MVA. These include:
Other symptoms in common with Vasospastic angina include:
It is not known for certain what causes MVA. However, there are some conditions and lifestyle choices that can make it more likely for an individual to develop MVA or trigger an episode of chest pain.
Causes and Triggers include:
MVA tends to effect women more than men.
Learn more about the diagnosis process and treatment options available for microvascular angina.
Following a thorough history taking and evaluation of the patient’s symptoms, the following tests may be offered depending on availability.
Many medications are offered to try and improve the ability of the small blood vessels to function normally. It can take a great deal of time and patience to find the best combination of medication to manage an individual’s symptoms of MVA. These can include:
Whilst Nitrates are usually effective in treating vasospasms, they are not always as useful in treating the angina in some patients living with MVA.
GTN can be taken in several ways. Short acting when the GTN is absorbed quickly into the blood stream and the effects wear off quickly or longer acting compounds that release the GTN slowly into the person’s blood stream over time.
Short acting GTN medications include:
Slow release GTN medications include:
Input from a pain management specialist may be helpful to advise on medication and other treatments to help manage altered pain perception if appropriate.
As with Vasospastic angina, some individuals may do well with medication and lifestyle changes. However, some people still continue to experience ongoing debilitating symptoms of angina, breathlessness and an inability to exercise.
Microvascular Angina is a long term heart condition which research is now suggesting not only impacts on a person’s quality of life but also increases their risks of experiencing heart problems in the future such as heart attacks or heart function issues.
Many people do find ways to live as well as possible with Microvascular angina.
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