Small vessel disease, which is also called coronary microvascular disease, is a disease that affects the small arteries in the heart. These small arteries normally expand to provide extra blood to your heart when you are exercising or exerting yourself. They contract when you are at rest. Small vessel disease is caused by a narrowing of these tiny arteries. This narrowing can be caused by spasms in the artery, damage to the artery walls or a build-up of a fatty substance (called plaque) in the artery.
Small vessel disease is not the same as coronary artery disease. Coronary artery disease affects the large arteries in the heart. These large arteries are responsible for carrying oxygen-rich blood to your heart all the time. When these arteries are blocked or narrowed, your heart muscle doesn't get the blood and oxygen it needs to work properly. This can cause a heart attack.
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The most common symptom of small vessel disease is angina (say: "ann-ji-na"). Angina often feels like a squeezing pain or a pressing feeling in the chest. The pain of angina may make you sweat or make it hard to catch your breath. You may feel pain in your arm, neck, jaw or shoulder as well as in your chest. It is like the symptoms of a heart attack, but it usually happens when you are exercising or being active.
Other symptoms of small vessel disease can include:
If left untreated, small vessel disease can make your heart work harder to pump blood. This can put you at risk for heart attack and heart failure.
Women are at higher risk for small vessel disease. This may be because of hormone levels, and the risk increases after menopause. Other risk factors include:
If you have any of the symptoms of small vessel disease, talk to your doctor. Your doctor will perform tests to determine that your symptoms are not being caused by a blockage in your large coronary arteries.
If you are having chest pain that extends from your chest into the jaw, left arm or left shoulder, get medical help immediately.
If you have small vessel disease, your doctor may prescribe medicine to help control your symptoms or keep your arteries from narrowing. Because the arteries are so small, surgery is not an option. Your doctor will talk to you about which medicine is best for you. Your doctor will also want to schedule regular check-ups with you to monitor how you are doing.
The best way to prevent small vessel disease is by controlling your risk factors. This may include:
National Heart, Lung and Blood Institute (NHLBI). What Is Coronary Microvascular Disease?. Accessed May 11, 2010
Mayo Foundation for Medical Education and Research. Small Vessel Disease. Accessed May 11, 2010
Written by familydoctor.org editorial staff