Dr. Leslie Cho, Director of Women’s Cardiovascular Center and Section Head, Preventive Cardiology

What is microvascular coronary disease?

Microvascular Coronary disease (MCD) is the narrowing of the small blood vessels that branch off the coronary arteries and send oxygen-rich blood to the heart muscle. This decreases the amount of blood that goes to the heart muscle, which leads to chest pain (angina). The condition is also called microvessel disease or small vessel heart disease. These narrowings are in arteries too small to see with routine coronary angiography during heart catheterization.

What are the symptoms of microvascular coronary disease?

The most common symptom of MCD is chest pain (angina) that often lasts at least 10 minutes and up to an hour. The chest pain usually occurs with exercise or stress, but can happen any time.

Microvascular Coronary Disease increases your risk of heart attack.

If you have chest pain:

Call 911 or go to the closest emergency room immediately if:

  • Your chest pain does not go away after taking two doses of nitroglycerin
  • You are having other heart attack symptoms
  • You feel like you're going to pass out

What causes of microvascular coronary disease?

Microvascular coronary disease involves damage to the walls of the affected arteries (referred to as endothelial dysfunction). This damage causes narrowing which may be aggravated by further spasms. The condition is most common among women, especially after menopause, but men can also have MCD.

Unlike coronary artery disease, MCD is not caused by “clogged arteries” (arteries with a build-up of plaque). However, both conditions have many of the same risk factors.

Risk factors for MCD include:

  • Smoking
  • High cholesterol
  • Diabetes
  • High blood pressure (hypertension)
  • Lack of exercise
  • Being overweight or obese
  • Eating an unhealthy diet
  • Rheumatologic disorders such as systemic lupus erythematosus or rheumatoid arthritis

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