The smaller blood vessels that branch out from the major coronary arteries of the heart can also develop blockages just like the coronary arteries. The condition, referred to as coronary small vessel disease or microvascular coronary disease, is seen more commonly in women and presents with similar symptoms as coronary artery disease (CAD).
All organs have major arteries and small blood vessels for the blood supply. The primary function of a small vessel is to supply blood to the tissue cells of a particular organ. The small vessels in the heart expand and contract, supplying oxygen-rich blood to it.
Small vessel disease symptoms
Dr Thejaswi N Marla, cardiothoracic vascular surgeon, Fortis Malar Hospital, Chennai, says the diameter of a small vessel in the Indian population is usually less than a millimeter, while that of the main artery is about 1.5 to 3 millimeters. “Any atherosclerotic condition in the small vessels is termed small vessel disease or branched vessel disease. While there may be no issues with the major coronary artery, one might continue to experience chest pain or angina since the vessel that’s supposed to supply blood to the particular part of the organ is blocked. This creates a major demand-supply mismatch,” he explains.
According to experts, the typical symptoms of small vessel disease include chest pain or angina, breathlessness, palpitations and fainting spells (also called syncope).
What causes small vessel disease?
The major risk factors for microvascular coronary disease include:
- Diabetes
- Hypertension
- Smoking and alcohol consumption
- Genetic predisposition
- High cholesterol levels
The condition is suspected when an individual experiences the symptoms despite an angiogram not revealing any major blockages in the main coronary arteries. An echocardiogram along with a positive treadmill test, among others, can help confirm the diagnosis.
Treatment
Dr Jyoti Kusnur, interventional cardiologist, Manipal Hospital, Goa, says the condition is not prevalent and is seen more among women. “There is no particular age group at which one can develop the condition. It can occur pre- or post-menopause in women. It is seen in young women in their 40s as well. The reason for this could be hormonal issues, as cells respond differently to different hormones,” she adds.
However, unlike CAD, where multiple treatment options like medicines, stents and bypass surgery are available, small vessel disease is only treated with medications that help improve blood flow to the cells.
How serious is small vessel disease?
Generally, small vessel disease is not life-threatening; it usually does not lead to a sudden cardiac arrest or heart attack, as in the case of CAD. Those with the condition can usually lead a normal lifespan. However, the quality of life can be affected due to recurrent chest pains and other manifestations.
Dr Kusnur elaborates, “For instance, if the main pipeline of a city gets blocked, the entire city can come to a halt; it’s a major emergency. But small vessel disease is like a pipeline to a house getting blocked. It won’t affect the entire city or lead to sudden catastrophic effects in general.”
Dr Marla says besides medications and regular follow-ups, the condition can be managed and prevented by leading a healthy lifestyle and keeping diabetes, blood pressure and cholesterol levels in check.
Takeaways
- Coronary small vessel disease or microvascular coronary disease refers to a condition where the small blood vessels supplying blood to the tissues of the heart get blocked. It is more commonly seen in women.
- The symptoms of the condition are similar to those of coronary artery disease, which include chest pain, breathlessness and palpitations. Additionally, comorbidities like diabetes, hypertension, smoking and alcoholism add to its risk.
- The condition can only be treated with medications. In addition, it can be managed or prevented by maintaining a healthy lifestyle and having good control over diabetes, hypertension and other comorbidities.
