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.
Source: http://www.mayoclinic.com
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 â 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 â 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.
Source: http://www.mayoclinic.com
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.
Source: http://www.mayoclinic.com
Because large vessel coronary artery disease and small vessel disease have the same signs and symptoms, it's likely your doctor will check the main arteries in your heart first. If no problems are found, then your doctor might test for small vessel disease.
To diagnose small vessel disease, your doctor will also ask you about your medical history and family history of heart disease. During your exam your doctor will likely check for high cholesterol and diabetes.
The tests for small vessel disease are similar to those for other types of heart disease and include:
Stress test with imaging. You'll either exercise on a treadmill or a bike or take a medication that raises your heart rate to mimic the effect of exercise.
Images will be taken of your heart using ultrasound images (echocardiogram) or with nuclear imaging scans to assess the blood flow to your heart muscle.
If your doctor can't find blockages in your main arteries based on these tests, you might have an additional test to check for blockages in the smaller arteries of your heart:
Endothelial dysfunction test. The endothelium is a layer of cells that line all of your blood vessels. When the endothelium isn't functioning well, the blood vessels can't expand properly.
To test endothelial function, a wire is threaded through a catheter inserted in one of your coronary arteries and a medication is injected into the artery that causes the small vessels in your heart to open. Then the blood flow through those vessels is measured.
This invasive test is the surest way to detect small vessel disease. Researchers are looking at noninvasive methods of endothelial function.
Source: http://www.mayoclinic.com
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:
Source: http://www.mayoclinic.com
There are no studies about preventing small vessel disease, but it seems that controlling the disease's major risk factors â high blood pressure, high cholesterol and obesity â can help.
Things you can do that might reduce your risk include:
Exercise regularly. Regular exercise helps improve heart muscle function and keeps blood flowing through your arteries. It can also prevent a heart attack by helping you to achieve and maintain a healthy weight and control diabetes, elevated cholesterol and high blood pressure.
Exercise doesn't have to be vigorous. Walking 30 minutes a day five days a week can improve your health.
Source: http://www.mayoclinic.com
A dietary supplement that may be helpful for people with small vessel disease is L-arginine. This amino acid that's normally used by the body to help metabolize protein may help treat symptoms of small vessel disease by relaxing your blood vessels. This therapy shouldn't be used in anyone who's already had a heart attack.
Talk to your doctor before adding a supplement to your treatment to ensure that it won't interfere with medications you take.
Source: http://www.mayoclinic.com
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.
Source: http://www.mayoclinic.com
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