Small vessel disease
DEFINITION
Small vessel disease is a condition in which the small arteries in the heart become narrowed. Small vessel disease 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 usually diagnosed after a doctor checks for blockages in the main arteries of the heart but finds little or no narrowing in the large vessels, even though your symptoms persist.
Although anyone can have small vessel disease, it’s more common in women and in people who have diabetes or high blood pressure. Small vessel disease is treatable but can be difficult to detect.
CAUSES
While the larger arteries in the heart are responsible for pumping blood through your heart, the small vessels expand when you’re active and then contract while you’re at rest.
The large vessels in your heart can become narrowed or blocked through atherosclerosis, a condition in which fatty deposits build up in the arteries. In small vessel disease, the narrowing of the small vessels in the heart makes it so they can’t expand properly when you’re active. As a result, you don’t get an adequate supply of oxygen-rich blood. This inability to expand is called endothelial dysfunction. This problem may cause your small vessels to actually become smaller when you’re active or under emotional stress. The reduced blood flow through the small vessels causes chest pain and other symptoms similar to those you’d have if you were having angina or a heart attack.
SYMPTOMS
Small vessel disease symptoms include:
- Chest pain, squeezing or discomfort
- Chest pain associated with discomfort in your left arm or jaw
- Chest pain that worsens with daily activities and at times of emotional stress
- Neck, shoulder, upper back or abdominal discomfort
- Shortness of breath
- Unusual fatigue
- A loss of energy
- Trouble sleeping
If you’ve been treated for coronary artery disease with angioplasty and stents and your signs and symptoms haven’t gone away, you may also have small vessel disease.
When to see a doctor
If you’re having chest pain along with other signs and symptoms — such as shortness of breath, sweating, nausea, dizziness, or pain that radiates beyond your chest to one or both of your arms or your neck — seek emergency medical care immediately.
If you’re having symptoms such as fatigue and abdominal pain, it might be difficult to tell if your signs and symptoms are due to small vessel disease, but if you have chest pain, see your doctor to find out the cause.
