Coronary microvascular dysfunction

Concerns the small blood vessels of the heart, the coronary microvasculature.

The coronary microvascular carries most of the blood flow to the heart muscle, delivering oxygen.

It is suggested that small intramyocardial arterioles constrict in microvascular angina causing ischemic pain that is less predictable than with typical epicardial coronary artery disease.

Conditions that increase the risk of coronary microvascular to dysfunction or hypertension, diabetes, high cholesterol, smoking, autoimmune disease, and prior breast cancer treatment with radiation.

The small blood vessels of the heart can become unhealthy when the endothelium is damaged.

Plaque buildup in large coronary arteries can contribute to abnormal blood flow which can cause problems with the blood supply to the heart, causing chest pain, shortness of breath, heart attack, and heart failure.

The coronary microvascular function testing is recommended for patients having chest pain, shortness of breath, abnormal stress test, a heart attack or clinically indicated angiography without blockage of the large coronary arteries.

Treatment of coronary microvascular dysfunction is to lower the chance of worsening symptoms to control and avoid myocardial infarction and heart failure.

Medications indicated include those to lower cholesterol and blood pressure, antiplatelet drugs, and medications to relieve chest pain such as alpha and beta blockers or calcium channel blockers.

Tests used to check for coronary microvascular dysfunction include invasive functional coronary angiography, cardiac magnetic resonance imaging, or pet scans.

A majority of individuals with coronary microvascular dysfunction or women, accounting for 60-75% of patients.

Women have a greater ability to whiten and narrow their arteries.

Women in addition experience relatively more pain sensations than men leading to more perceived chest pain.

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