What Is Coronary Microvascular Disease?

Coronary microvascular disease (MVD) is heart disease that affects the tiny coronary (heart) arteries. In coronary MVD, the walls of the heart's tiny arteries are damaged or diseased.

Coronary MVD is different from traditional coronary heart disease (CHD), also called coronary artery disease. In CHD, a waxy substance called plaque (plak) builds up in the large coronary arteries.

Plaque narrows the heart's large arteries and reduces the flow of oxygen-rich blood to your heart muscle. The buildup of plaque also makes it more likely that blood clots will form in your arteries. Blood clots can mostly or completely block blood flow through a coronary artery.

In coronary MVD, however, the heart's tiny arteries are affected. Plaque doesn't create blockages in these vessels as it does in the heart's large arteries.

Coronary Microvascular Disease

Figure A shows the small coronary artery network (microvasculature), containing a normal artery and an artery with coronary MVD. Figure B shows a large coronary artery with plaque buildup.

Overview

Studies have shown that women are more likely than men to have coronary MVD. Many researchers think the disease is caused by a drop in estrogen levels during menopause combined with traditional heart disease risk factors.

Both men and women who have coronary MVD often have diabetes or high blood pressure. Some people who have coronary MVD may have inherited heart muscle diseases.

Diagnosing coronary MVD has been a challenge for doctors. Standard tests used to diagnose CHD aren't designed to detect coronary MVD. More research is needed to find the best diagnostic tests and treatments for the disease.

Outlook

Most of what is known about coronary MVD comes from the National Heart, Lung, and Blood Institute's Wise study (Women's Ischemia Syndrome Evaluation).

The WISE study started in 1996. The goal of the study was to learn more about how heart disease develops in women.

Currently, research is ongoing to learn more about the role of hormones in heart disease and to find better ways to diagnose coronary MVD.

Studies also are under way to learn more about the causes of coronary MVD, how to treat the disease, and the expected health outcomes for people with coronary MVD.

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