Coronary Microvascular Disease (MVD)

What is coronary microvascular disease?

冠状动脉微血管疾病(有时被称为小动脉疾病或小血管疾病)是一种心脏疾病，它影响从大动脉分支出来的微小冠状动脉血管的壁和内层 冠状动脉. Coronary heart disease (CHD), also called coronary artery disease, 包括斑块的形成，可以阻止血液流向心脏肌肉. 冠状动脉MVD, the heart's coronary artery blood vessels don't have plaque, 但是血管内壁的损伤会导致痉挛，减少流向心肌的血液. 除了, 冠状动脉主干分支的小动脉异常也可能导致冠状动脉MVD.

See an illustration of 冠状动脉.

女性更容易患上冠状动脉微血管疾病，尤其是在年轻女性中. 冠状动脉MVD的危险因素与冠状动脉疾病相同，包括 糖尿病, 高血压 和 高胆固醇.

Diagnosing coronary MVD was previously a challenge. PET扫描和其他类型的成像现在可以测量冠状动脉的血流，并可以在非常小的血管中检测冠状动脉MVD.

According to the National Heart, Lung, 和 Blood Institute's WISE-R研究(link opens in new window) (Women's Ischemia Syndrome Evaluation), 研究正在进行中，以了解更多关于激素在心脏病中的作用，并找到更好的方法来诊断冠状动脉MVD.

Other names for coronary microvascular disease

• 心脏综合征X
• Nonobstructive coronary heart disease

What causes coronary microvascular disease?

Many researchers think some of the risk factors that cause 动脉粥样硬化 may also lead to coronary MVD. 动脉粥样硬化是一种斑块在动脉内积聚的疾病.

Risk factors for 动脉粥样硬化 include:

• 不健康的 blood cholesterol levels
• 高血压
• 吸烟
• 糖尿病
• 超重和肥胖
• Lack of physical activity
• 不健康的饮食
• 老年
• Family history of heart disease

Underst和 your risk for coronary microvascular disease

如果女性在成年后的任何时候雌激素水平低于正常水平，她们可能有患冠状动脉心血管疾病的风险. Low estrogen levels before 更年期 会增加年轻女性患冠状动脉心血管疾病的风险 压力 和 a functioning problem with the ovaries.

Women who have 高血压 before 更年期, especially high systolic blood pressure, are at increased risk for coronary MVD. 经历剧烈或不规则更年期症状的女性也更容易出现心脏问题. 绝经期后, 女性往往有更多传统的动脉粥样硬化风险因素, which may also put them at higher risk for coronary MVD.

患有心脏病的人更有可能有更糟糕的结果，比如心脏病 心脏病, if they also have anemia. 这是因为贫血被认为会减缓修复受损血管所需细胞的生长.

冠状动脉微血管疾病的体征和症状是什么?

Women with coronary MVD often have 胸部疼痛 called angina, also called 微血管心绞痛. 他们可能会经历长沙巴足球体育平台的心绞痛，也可能在休息时出现心绞痛. 

Other signs 和 symptoms of coronary MVD are:

• 呼吸急促（气促）
• 睡眠问题
• 乏力
• 精力不足

经历冠状动脉MVD症状的人通常在日常活动和精神压力时期首先注意到它们. They occur less often during physical activity or exertion. 这与冠状动脉和主要分支的疾病不同, in which symptoms usually first appear during physical activity. If you have coronary MVD, learn the warning signs of a 心脏病 和 warning signs of a 心脏病 in women.

Diagnosis of Coronary Microvascular Disease

您的医生或其他医疗保健专业人员将根据您的病史诊断冠状动脉MVD, a physical exam 和 test results. 您还将被评估任何心脏病的风险因素，包括高胆固醇, 代谢综合征, 糖尿病 和 being overweight or obese.

诊断测试

冠状动脉MVD和传统心脏病的危险因素通常是相同的. Some recommend tests for heart disease include:

• Coronary angiography (PDF)
• 压力测试
• Coronary magnetic resonance (CMR) imaging

St和ard tests for CHD may not be able to detect coronary MVD. These tests look for blockages in the large 冠状动脉. Coronary MVD affects the tiny 冠状动脉. 如果你有心绞痛，但检查显示你的冠状动脉正常, you could still have coronary MVD. Additional testing can confirm the diagnosis.

冠状动脉MVD症状通常首先出现在日常工作中. 正因为如此，你可能会被要求填写一份名为 Duke Activity Status Index (DASI). DASI包括关于你日常活动能力的问题, 比如购物, cooking 和 going to work.

DASI结果有助于确定诊断冠状动脉MVD还需要哪些附加检查.

Duke Activity Status Index (DASI)

杜克活动状态指数是一份自我管理的问卷，用来衡量一个人的功能能力. It can be used to get a rough estimate of peak oxygen uptake.

1. 你能照顾好自己(吃饭、穿衣、洗澡或上厕所)吗??
2. Can you walk indoors, such as around your house?
3. Can you walk a block or two on level ground?
4. Can you climb a flight of stairs or walk up a hill?
5. Can you run a short distance?
6. 你能做家务吗，比如打扫房间或洗碗?
7. Can you do moderate work around the house, 比如吸尘, sweeping floors or carrying in groceries?
8. Can you do heavy work around the house, such as scrubbing floors or lifting 和 moving heavy furniture?
9. 你会做院子里的工作吗，比如耙树叶、除草或推电动割草机?
10. Can you have sexual relations?
11. Can you participate in moderate recreational activities, 比如高尔夫, 打保龄球, 跳舞, doubles tennis or throwing a baseball or 足球?
12. Can you participate in strenuous sports, 比如游泳, 网球单打, 足球, 篮球或滑雪?

杜克活动状态指数(DASI) =“是”回复的总和___________

VO₂峰值= (0).43 x DASI) + 9.6

VO₂peak = ___________ ml/kg/min ÷ 3.5 ml/kg/min = __________ METS

You may also be tested for anemia. 贫血被认为会减缓修复受损血管所需细胞的生长.

寻找更好的方法来检测和诊断冠状动脉MVD的研究正在进行中.

Treatment of Coronary Microvascular Disease

缓解疼痛是治疗冠状动脉MVD的主要目标之一. 治疗还用于控制风险因素和其他症状.

Treatments may include medicines such as:

• 胆固醇药物 to improve cholesterol levels.
• Blood pressure medications to lower 高血压 和 decrease the heart's workload.
• 抗血小板药物 to help prevent blood clots.
• 药物 松弛血管，包括-受体阻滞剂，钙通道阻滞剂和硝酸甘油.
• Nitroglycerin to treat 胸部疼痛.

Prevention of Coronary Microvascular Disease

No studies have been done on how to prevent coronary MVD. 研究人员还不知道预防冠状动脉MVD与预防心脏病有何不同.

Knowing your family history of heart disease, 以下生活方式的改变和持续的护理可以帮助你降低患心脏病的风险.

• 控制血压
• 控制胆固醇
• 降低血糖
• 得到积极的
• 吃得更好
• 减肥或控制体重
• 停止吸烟 

如果生活方式的改变还不够，你的医生可能会开一些药物来控制你的风险因素. Take all of your medicines as prescribed.