Microvascular angina: Difference between revisions
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{{Infobox medical condition | |||
[[File:Clogged_Heart_Artery.jpg| | | name = Microvascular angina | ||
| image = [[File:Clogged_Heart_Artery.jpg|250px]] | |||
| caption = Illustration of a clogged heart artery | |||
| synonyms = Cardiac syndrome X, Microvascular dysfunction | |||
| specialty = [[Cardiology]] | |||
| symptoms = [[Chest pain]], [[fatigue]], [[shortness of breath]] | |||
| complications = [[Heart failure]], [[myocardial infarction]] | |||
| onset = Typically middle-aged women | |||
| duration = Chronic | |||
| causes = [[Coronary microvascular dysfunction]] | |||
| risks = [[Hypertension]], [[diabetes]], [[smoking]], [[obesity]] | |||
| diagnosis = [[Coronary angiography]], [[stress test]], [[MRI]] | |||
| differential = [[Coronary artery disease]], [[angina pectoris]] | |||
| treatment = [[Medications]], [[lifestyle changes]], [[cardiac rehabilitation]] | |||
| medication = [[Beta blockers]], [[calcium channel blockers]], [[nitrates]] | |||
| prognosis = Variable, often chronic | |||
| frequency = Common in women | |||
}} | |||
'''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''', 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 === | === 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. | 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 === | === 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. | 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 === | === 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. | 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 === | ||
Treatment for microvascular angina focuses on relieving symptoms and improving quality of life. Common treatments include: | Treatment for microvascular angina focuses on relieving symptoms and improving quality of life. Common treatments include: | ||
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* [[Statins]] to reduce inflammation and improve endothelial health. | * [[Statins]] to reduce inflammation and improve endothelial health. | ||
* Lifestyle modifications such as regular [[exercise]], a [[heart-healthy diet]], and [[stress management]]. | * Lifestyle modifications such as regular [[exercise]], a [[heart-healthy diet]], and [[stress management]]. | ||
=== Prognosis === | === 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. | 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. | ||
== See Also == | |||
== | |||
* [[Coronary artery disease]] | * [[Coronary artery disease]] | ||
* [[Angina pectoris]] | * [[Angina pectoris]] | ||
* [[Endothelial dysfunction]] | * [[Endothelial dysfunction]] | ||
* [[Ischemic heart disease]] | * [[Ischemic heart disease]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
Latest revision as of 05:28, 6 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Microvascular angina | |
|---|---|
| |
| Synonyms | Cardiac syndrome X, Microvascular dysfunction |
| Pronounce | N/A |
| Specialty | Cardiology |
| Symptoms | Chest pain, fatigue, shortness of breath |
| Complications | Heart failure, myocardial infarction |
| Onset | Typically middle-aged women |
| Duration | Chronic |
| Types | N/A |
| Causes | Coronary microvascular dysfunction |
| Risks | Hypertension, diabetes, smoking, obesity |
| Diagnosis | Coronary angiography, stress test, MRI |
| Differential diagnosis | Coronary artery disease, angina pectoris |
| Prevention | N/A |
| Treatment | Medications, lifestyle changes, cardiac rehabilitation |
| Medication | Beta blockers, calcium channel blockers, nitrates |
| Prognosis | Variable, often chronic |
| Frequency | Common in women |
| Deaths | N/A |
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[edit]
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[edit]
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[edit]
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[edit]
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.
Prognosis[edit]
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.
