Small vessel disease is sometimes called coronary microvascular disease or small vessel heart disease. It is usually diagnosed after checks for blockages in the main arteries of the heart but finds little or no narrowing in the large vessels, even though the symptoms continue.

Small vessel disease is a condition in which the small arteries in the heart become narrowed. Small vessel disease causes symptoms of heart disease, such as chest pain (angina).

Anyone can have small vessel disease, but it is more common in women and in people who have diabetes or high blood pressure. Small vessel disease is treatable but can be difficult to detect.



The symptoms include:

  • Chest pain associated with discomfort in your left arm or jaw
  • Chest pain, squeezing or discomfort
  • Chest pain that worsens with daily activities and at times of emotional stress
  • Neck, shoulder, upper back or abdominal discomfort
  • Shortness of breath
  • Unusual fatigue
  • A loss of energy
  • Trouble sleeping



While the larger arteries in the heart are responsible for pumping blood through the heart, the small vessels expand during an activity and then contract during rest.

The large vessels in your heart can become narrowed or blocked through atherosclerosis, a condition in which fatty deposits build up in the arteries. In small vessel disease, the narrowing of the small vessels in the heart makes it so that they can't expand properly when a person is active. As a result, the person does not get an adequate supply of oxygen-rich blood.


 Risk Factors

Risk factors for small vessel disease include:

  • High cholesterol
  • High blood pressure
  • Obesity (body mass index of 30 or higher)
  • Tobacco use
  • Unhealthy diet
  • Inactive lifestyle
  • Diabetes
  • Insulin resistance
  • Being female
  • An estrogen deficiency, in women
  • Polycystic ovarian syndrome
  • Increasing age, older than 45 in men and older than 55 in women



Because small vessel disease can make it harder for the heart to pump blood to the rest of the body, small vessel disease can cause serious problems if left untreated, such as:

  • Coronary artery spasm
  • Heart attack
  • Sudden cardiac death
  • Heart failure



There are no scientific studies to show what to do to prevent small vessel disease, but controlling the disease's major risk factors, high blood pressure, high cholesterol and obesity can help. To reduce the risks:

  • Don't smoke or use other tobacco products.
  • Eat a heart-healthy diet.
  • Exercise regularly.
  • Check your cholesterol.
  • Control your blood pressure.
  • Maintain a healthy weight.
  • Manage stress.
  • Control blood sugar levels if you have diabetes.