Microvascular angina
[citation needed] Some studies have found an increased risk of other vasospastic disorders in cardiac microvascular angina patients, such as migraine and Raynaud's phenomenon.
Treatment typically involves beta-blockers, such as metoprolol, however beta blockers can make coronary spasms worse.
Patients often experience myocardial ischemia symptoms, such as heaviness, tightness, pressure or squeezing in the chest area, which can also include sweating, nausea, shortness of breath (dyspnea), fatigue.
The narrowing of these vessels may lead to lack of oxygen in specific areas of the cardiac muscle causing chest pain.
[9] This condition is typically characterized by a series of structural and functional changes within the heart's microcirculation, such as endothelial dysfunction (which affects the inner lining of blood vessels), microvascular arteriolar remodeling (changes in the vessel structure) such as intimal thickening, smooth muscle cell proliferation, perivascular fibrosis, and increased microvascular resistance (which impedes blood flow).
[10] In a large percentage of patients, there is a finding of systemic microvascular abnormalities, causing reduced blood flow in the microvasculature of the cardiac muscles.
When the blood vessels constrict and fail to dilate there is decreased oxygen levels to the cardiac muscles resulting in hypoxia which lead to chest pain.
[10] It is characterized by luminal obstruction, vascular-wall infiltration, vascular remodeling, perivascular fibrosis and capillary rarefaction.
[10] In this type individuals may have impaired vasodilatory capacity and endothelial function, leading to reduced coronary blood flow and compromised myocardial perfusion, especially during stress or increased demand.
[10] Endothelial function and vasodilatory capacity is relatively preserved resulting in adequate myocardial perfusion under resting conditions.
However, sedentary and overweight individuals with a family history of type 2 diabetes should be tested regularly to determine whether they have irregular levels of glucose or lipids, or blood pressure abnormalities,[12] factors which are usually associated with microvascular angina.
Patients should start following healthier diets which are low in saturated fats, and should participate in regular physical activities.
Microvascular angina was first described by H. G. Kemp in 1973 as angina-like chest pain in the absence of angiographic evidence of coronary obstruction.
