Small vessel disease is a condition in which the walls of the small arteries in the heart are damaged. The condition causes signs and symptoms of heart disease, such as chest pain (angina).
Small vessel disease is sometimes called coronary microvascular disease or small vessel heart disease. It’s often diagnosed after a doctor finds little or no narrowing in the main arteries of your heart, despite your having symptoms that suggest heart disease.
Small vessel disease is more common in women and in people who have diabetes or high blood pressure. The condition is treatable but can be difficult to detect.
Small vessel disease: clogging or narrowing of the arteries that supply blood to your heart can occur not only in your heart’s largest arteries (the coronary arteries) but also in your heart’s smaller blood vessels.
Small vessel disease signs and symptoms include:
If you’ve been treated for coronary artery disease with angioplasty and stents and your signs and symptoms haven’t gone away, you might also have small vessel disease.
If you’re having chest pain and other signs and symptoms — such as shortness of breath, sweating, nausea, dizziness, or pain that radiates beyond your chest to one or both of your arms or to your neck — seek emergency medical care.
It might be hard to tell if your symptoms are due to small vessel disease, especially if you don’t have chest pain. If you do have chest pain, see your doctor to find out the cause.
Experts suspect that the causes of small vessel disease are the same as the causes for disease of the larger vessels of the heart, such as high blood pressure, high cholesterol, obesity and diabetes.
The large vessels in your heart can become narrowed or blocked through a condition in which fatty deposits build up in the arteries (atherosclerosis). In small vessel disease, damage to the small vessels affects their ability to expand (endothelial dysfunction). As a result, your heart doesn’t get enough oxygen-rich blood.
Small vessel disease is more common in women. Risk factors include:
It’s not clear why the same risk factors, such as obesity or an inactive lifestyle, cause some people to develop small vessel disease instead of large vessel coronary artery disease.
Because small vessel disease can make it harder for the heart to pump blood to the rest of the body, the condition, if untreated, can cause serious problems, such as:
There are no studies about preventing small vessel disease, but it seems that controlling the disease’s major risk factors — high blood pressure, high cholesterol and obesity — can help.
Things you can do that might reduce your risk include:
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