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What is Coronary Microvascular Disease?


Coronary microvascular disease (CMVD) is heart disease that affects the walls and inner lining of tiny coronary artery blood vessels that branch off from the larger coronary arteries. Coronary heart disease (CHD), also called coronary artery disease, involves plaque formation that can block blood flow. In coronary MVD, the heart's tiny coronary artery blood vessels do not have plaque, but damage to the inner walls of the blood vessels that can lead to spasms and decrease blood flow to the heart muscle.


Women more frequently develop coronary microvascular disease and it occurs particularly in younger women; however, men and women who have coronary MVD often have diabetes, high blood pressure or a family history of cardiomyopathy


Diagnosing coronary MVD has been a challenge for doctors. Standard tests used to diagnose coronary heart disease are not designed to detect coronary MVD, so more research is needed to find the best diagnostic tests and treatments for the disease.

According to the National Heart, Lung, and Blood Institute's Wise study (Women's Ischemia Syndrome Evaluation), research is ongoing to learn more about the role of hormones in heart disease and to find better ways to diagnose coronary MVD.


What Causes Coronary Microvascular Disease?


The same risk factors that cause atherosclerosis may cause coronary microvascular disease (CMVD). Atherosclerosis is a disease in which plaque builds up inside the arteries.

Risk factors for atherosclerosis include:


Unhealthy blood

cholesterol levels

High blood pressure



Overweight and obesity


Unhealthy diet

Older age

Family history of heart disease

Understand Your Risk for Coronary Microvascular Disease?

Women may be at risk for coronary MVD if they have lower than normal estrogen levels at any point in their adult lives. Low estrogen levels before menopause can raise younger women's risk for coronary MVD and can be caused by stress and also a functioning problem with the ovaries.

When you hear hoof beats, think zebras!

Women who have high blood pressure before menopause, especially high systolic blood pressure, are at increased risk for coronary MVD. After menopause, women tend to have more of the traditional risk factors for atherosclerosis, which also puts them at higher risk for coronary MVD.

Women who have heart disease are more likely to have a worse outcome, such as a heart attack, if they also have anemia because anemia is thought to slow the growth of cells needed to repair damaged blood vessels.

What Are the Signs and Symptoms of Coronary Microvascular Disease?

Women with coronary MVD often have chest pain called angina, also called microvascular angina usually lasting longer than 10 minutes, and it can last longer than 30 minutes.

Other signs and symptoms of coronary MVD are:


shortness of breath

sleep problems


lack of energy

People that experience coronary MVD symptoms often first notice them during their routine daily activities and times of mental stress but less often during physical activity or exertion. This differs from heart disease, in which symptoms often first appear while a person is being physically active. If you have coronary MVD, learn the warning signs of a heart attack and the warning signs of a heart attack in women.

information from the American Heart Association's website


Heart attacks often present differently in women than in men. It is important that you learn the signs and symptoms even if you don't have a history of heart disease in your family.  Heart disease kills more women than all cancers combined and is responsible for the deaths of over half a million Americans every year. 1 in 3 women die every year from heart attack or stroke. Know your risks stay active and eat a healthy diet and most importantly trust and listen to your yourself, no one knows your heart and body like you do.

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