WHAT IS SMALL VESSEL DISEASE: SYMPTOMS, CAUSES, DIAGNOSIS, AND MORE

Small vessel disease is a disorder in which the walls of the heart's small arteries do not function correctly. This lowers the flow of oxygen-rich blood to the heart, resulting in chest discomfort (angina), shortness of breath, and other heart disease symptoms.

Small vessel disease is also known as:

• Coronary microvascular disease

• Microvascular endothelial dysfunction

Small vascular disease may be treated, although it might be difficult to identify. Despite the existence of symptoms suggestive of heart disease, the illness is often detected when a health care professional detects little or no constriction in the major arteries of the heart.

Women and adults with diabetes or high blood pressure are more likely to develop small vessel disease.

WHAT ARE THE SYMPTOMS FOR SMALL VESSEL DISEASE?

Signs and symptoms of small vessel disease include:

• Angina is characterized by chest pain, tightness, or discomfort that worsens with exertion or mental stress.

• Pain in the left arm, jaw, neck, back, or abdomen, as well as chest pain

• Breathing difficulty

• fatigue and a lack of energy

If you've had angioplasty and stents for coronary artery disease and your symptoms haven't improved, you may have small vessel disease.

WHAT ARE THE CAUSES OF SMALL VESSEL DISEASE?

The tiny arteries do not relax (dilate) as they should in coronary small vessel disease. As a result, the heart receives insufficient oxygen-rich blood.

The causes of small vessel illness, according to experts, are the same as those of disorders affecting the bigger arteries of the heart, such as high blood pressure, high cholesterol, obesity, and diabetes.

WHAT ARE THE RISK FACTORS FOR SMALL VESSEL DISEASE?

Women are more likely than males to suffer from small vessel disease. Small vessel disease risk factors include:

• BMI of 30 or higher (obesity)

• Diabetes

• Men over the age of 45 and women over the age of 55

• Insulin sensitivity

• Polycystic ovarian syndrome (PCOS)

• Tobacco consumption

• Family history of the illness, particularly in women

• Hypertension

• Inactive way of life

• Unhealthy levels of cholesterol

• Unhealthy eating habits

WHAT ARE THE COMPLICATIONS OF SMALL VESSEL DISEASE?

Small vessel disease can impair the heart's ability to pump blood to the rest of the body. A heart attack is a potential consequence of small vessel disease.

HOW IS SMALL VESSEL DISEASE DIAGNOSED?

A physical exam and inquiries about your medical history and family history of heart disease are commonly used to identify small vessel disease. He or she will most likely use a stethoscope to listen to your heart.

Small vessel disease is diagnosed using the same tests as other kinds of heart disease, and these include:

• Stress test with imaging: A stress test assesses how the heart and blood vessels react to physical exertion. While attached to a cardiac monitor, you may be asked to walk on a treadmill or cycle a stationary bike. Alternatively, you may be given an IV medication to stimulate the heart in a similar manner to exercise. Ultrasound pictures (echocardiograms) or nuclear imaging scans are used to evaluate blood flow to the heart muscle.

• Coronary angiogram: This test determines if the major arteries leading to the heart are obstructed. A long, thin, flexible tube (catheter) is placed into a blood artery and directed to the heart, commonly in the groin or wrist. Dye is delivered to arteries in the heart through the catheter. The dye makes the arteries visible on X-rays and video.

During an angiography, further tests to evaluate blood flow via the heart may be performed.

• CT coronary angiogram: This second sort of angiography creates a sequence of pictures of the heart and its blood arteries using a strong X-ray scanner. You'll be lying on a lengthy table that will be pushed through a short, tunnel-like equipment (CT scanner). Blood vessels on CT scans are easier to observe when dye is administered through an IV in the arm or hand.

• Positron emission tomography (PET): This test measures blood flow to the heart muscle using a radioactive tracer and medicine. Following the injection of the tracer, you are normally placed in a doughnut-shaped machine to have pictures of your heart taken.

WHAT ARE THE TREATMENTS FOR SMALL VESSEL DISEASE?

The aims of small vessel disease treatment are to manage the constriction of small blood vessels, which can lead to a heart attack, and to reduce discomfort.

Small vessel disease medications may include:

• Nitroglycerin (Nitrostat, Nitro-Dur): By relaxing the coronary arteries and boosting blood flow, nitroglycerin pills, sprays, and patches can alleviate chest discomfort.

• Beta blockers: These medications reduce blood pressure and moderate the heart rate.

• ARBs and ACE inhibitors:  Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are medications that help widen blood arteries and reduce blood pressure. This makes the heart's job of pumping blood easier.

• Ranolazine (Ranexa): This drug alleviates chest discomfort by modifying salt and calcium levels.

• Aspirin: Aspirin can help to reduce inflammation and avoid blood clots.

• Metformin: This medication is commonly used to treat diabetes, but it can also enhance blood vessel health in people who do not have diabetes.

• Calcium channel blockers: These medications relax the muscles surrounding the coronary arteries, causing the blood vessels to open and increase blood flow to the heart. Calcium channel blockers also aid in the treatment of hypertension and coronary artery spasms.

• Statins: These drugs help decrease bad cholesterol, which leads to artery constriction. Statins also aid in the relaxation of blood vessels in the heart and the treatment of blood vessel injury.

If you've been diagnosed with small vessel disease, you'll need to see your doctor on a frequent basis.

HOME REMEDIES FOR SMALL VESSEL DISEASE

Small vessel disease can be prevented and managed with heart-healthy lifestyle modifications. Changes in lifestyle may include:

• Weight loss if you are not at a healthy weight

• Participating in frequent physical exercise

• Eating a low-salt diet rich in fruits, vegetables, lean protein, and entire grains

• Quitting smoking or using tobacco

HOW CAN SMALL VESSEL DISEASE BE PREVENTED?

You can lower your risk of small vessel disease by doing the following:

• Avoid smoking and other tobacco products: Stop smoking or using tobacco. If you're having problems stopping, go to your doctor.

• Consume a heart-healthy diet: Consume whole grains, lean meat, low-fat dairy, and fruits and vegetables. Limit your intake of salt, sugar, alcohol, saturated fat, and trans fats.

• Keep a healthy weight: Excess weight puts stress on the heart and can lead to high cholesterol, high blood pressure, and diabetes.

• Manage cholesterol: Inquire with your doctor about how frequently you should have your cholesterol levels tested. If your bad cholesterol (LDL cholesterol) levels are high, your doctor may recommend dietary modifications and medicines to help decrease your cholesterol levels and safeguard your cardiovascular health.

• Regular exercise is essential: Exercise improves cardiac muscle activity and maintains blood flowing via the arteries. Aim for at least 150 minutes of moderate activity per week, such as walking.

• Maintain blood pressure control: Inquire with your doctor about how regularly you should get your blood pressure checked. If you have high blood pressure or a history of heart disease, he or she may urge more regular examinations.

• Maintain blood sugar control: Work with your doctor to set blood sugar targets that are appropriate for you.

• Stress should be managed: Find techniques to alleviate emotional tension. Stress can be reduced by increasing physical activity, practicing mindfulness, listening to music, and connecting with others in support groups.