Microvascular angina: Difference between revisions

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'''Microvascular angina''' (MVA), also known as '''cardiac syndrome X''', is a [[medical condition]] characterized by symptoms of [[angina]], such as chest pain, despite normal coronary arteries. The cause of microvascular angina is thought to be abnormalities in the tiny blood vessels of the heart, the coronary microvasculature.
== Microvascular Angina ==


== Symptoms ==
[[File:Clogged_Heart_Artery.jpg|thumb|right|Illustration of a clogged heart artery, which can be related to microvascular angina.]]
The main symptom of microvascular angina is chest pain that varies in severity, frequency, and duration. Other symptoms may include discomfort in the arms, neck, jaw, shoulder, or back, shortness of breath, fatigue, and sleep disturbances.


== Causes ==
'''Microvascular angina''', also known as '''cardiac syndrome X''', is a condition characterized by chest pain (angina) that occurs due to abnormalities in the small blood vessels of the heart. Unlike typical angina, which is caused by blockages in the larger coronary arteries, microvascular angina involves the smaller coronary microvasculature.
Microvascular angina is caused by problems with the small blood vessels in the heart. These problems can include damage or disease in the walls of the blood vessels, or spasms in the blood vessels.


== Diagnosis ==
=== Pathophysiology ===
Diagnosis of microvascular angina can be challenging, as standard tests used to diagnose heart disease may not detect abnormalities in the small blood vessels. Tests that may be used include an exercise stress test, coronary angiography, and non-invasive imaging tests.
Microvascular angina is thought to result from dysfunction of the [[endothelium]] and smooth muscle cells in the small coronary arteries. This dysfunction leads to impaired [[vasodilation]] and increased [[vascular resistance]], which reduces blood flow to the heart muscle and causes ischemic pain. The exact mechanisms are not fully understood, but it is believed that [[inflammation]], [[oxidative stress]], and [[endothelial dysfunction]] play significant roles.


== Treatment ==
=== Symptoms ===
Treatment for microvascular angina focuses on relieving symptoms and may include medications to improve blood flow, lifestyle changes such as regular exercise and a healthy diet, and sometimes, procedures to improve blood flow to the heart muscle.
Patients with microvascular angina typically experience chest pain that is similar to that of [[stable angina]], but it may occur more frequently and last longer. The pain is often described as a pressure or tightness in the chest and may be accompanied by [[shortness of breath]], [[fatigue]], and [[dizziness]]. Unlike typical angina, the pain may not be relieved by [[nitroglycerin]] or rest.


== See also ==
=== Diagnosis ===
* [[Angina]]
Diagnosing microvascular angina can be challenging because standard tests for coronary artery disease, such as [[coronary angiography]], often show normal results. Diagnosis is typically made based on the patient's symptoms, exclusion of other causes of chest pain, and specialized tests such as [[coronary flow reserve]] measurement or [[magnetic resonance imaging]] (MRI) to assess microvascular function.
* [[Coronary artery disease]]
 
* [[Heart disease]]
=== Treatment ===
Treatment for microvascular angina focuses on relieving symptoms and improving quality of life. Common treatments include:
* [[Beta-blockers]] and [[calcium channel blockers]] to reduce heart workload and improve blood flow.
* [[ACE inhibitors]] or [[angiotensin II receptor blockers]] to improve endothelial function.
* [[Statins]] to reduce inflammation and improve endothelial health.
* Lifestyle modifications such as regular [[exercise]], a [[heart-healthy diet]], and [[stress management]].


== References ==
=== Prognosis ===
<references />
The prognosis for patients with microvascular angina varies. While the condition can be chronic and impact quality of life, it is generally not associated with the same risk of [[myocardial infarction]] or death as obstructive coronary artery disease. However, ongoing management and monitoring are important to prevent complications.


{{stub}}
== Related Pages ==
* [[Coronary artery disease]]
* [[Angina pectoris]]
* [[Endothelial dysfunction]]
* [[Ischemic heart disease]]


[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Medical conditions]]
[[Category:Angina]]

Revision as of 05:24, 16 February 2025

Microvascular Angina

Illustration of a clogged heart artery, which can be related to microvascular angina.

Microvascular angina, also known as cardiac syndrome X, is a condition characterized by chest pain (angina) that occurs due to abnormalities in the small blood vessels of the heart. Unlike typical angina, which is caused by blockages in the larger coronary arteries, microvascular angina involves the smaller coronary microvasculature.

Pathophysiology

Microvascular angina is thought to result from dysfunction of the endothelium and smooth muscle cells in the small coronary arteries. This dysfunction leads to impaired vasodilation and increased vascular resistance, which reduces blood flow to the heart muscle and causes ischemic pain. The exact mechanisms are not fully understood, but it is believed that inflammation, oxidative stress, and endothelial dysfunction play significant roles.

Symptoms

Patients with microvascular angina typically experience chest pain that is similar to that of stable angina, but it may occur more frequently and last longer. The pain is often described as a pressure or tightness in the chest and may be accompanied by shortness of breath, fatigue, and dizziness. Unlike typical angina, the pain may not be relieved by nitroglycerin or rest.

Diagnosis

Diagnosing microvascular angina can be challenging because standard tests for coronary artery disease, such as coronary angiography, often show normal results. Diagnosis is typically made based on the patient's symptoms, exclusion of other causes of chest pain, and specialized tests such as coronary flow reserve measurement or magnetic resonance imaging (MRI) to assess microvascular function.

Treatment

Treatment for microvascular angina focuses on relieving symptoms and improving quality of life. Common treatments include:

Prognosis

The prognosis for patients with microvascular angina varies. While the condition can be chronic and impact quality of life, it is generally not associated with the same risk of myocardial infarction or death as obstructive coronary artery disease. However, ongoing management and monitoring are important to prevent complications.

Related Pages