Coronary Microvascular Disease: a “trash basket diagnosis”?

by Carolyn Thomas  @HeartSisters

Dr. Juan Carlos Kaski, Head of the Cardiovascular Sciences Research Centre, St. George’s University of London in the U.K., explains an unusual cardiac diagnosis that I happen to share: Inoperable Coronary Microvascular Disease (MVD).

When I was at Mayo Clinic five months after my heart attack, cardiologists there referred to MVD as a “trash basket diagnosis” – not because the condition doesn’t exist, but because this disorder of the tiniest blood vessels in the heart is so often missed entirely. A correct diagnosis usually happens only after all other possible diagnoses are thrown out. It’s far more common in women and in people who have diabetes. It’s treatable, but can be very difficult to detect. Continue reading “Coronary Microvascular Disease: a “trash basket diagnosis”?”

His and hers heart disease

heart man womanby Carolyn Thomas  @HeartSisters

Should we invent a new name for women’s heart disease? A review on the topic of gender differences in heart disease reminds us what many heart attack survivors already know: when it comes to heart attacks, women are not just small men.

Standard cardiac treatment typically focuses on obstructive coronary artery disease, which up to half of women may not ever experience. In obstructive coronary artery disease, the large blood vessels in the heart can become blocked through atherosclerosis, a condition in which fatty cholesterol streaks build up in the arteries.

In fact, the Framingham Risk Score, based on a study of over 5,000 participants (and their descendents) followed since 1948, is the traditional measure of heart disease risk, yet this scale mistakenly classified almost 90% of women as low risk – which is hard to get your brain wrapped around given that more women than men die each year from heart disease.

But in small vessel disease, the narrowing of the very small arteries in the heart means they can’t expand properly. As a result, your heart muscles don’t get an adequate supply of oxygen-rich blood. This inability to expand is called endothelial dysfunction. This problem may cause your small vessels to become even smaller when you’re active or under emotional stress. The reduced blood flow through the small blood vessels causes chest pain and other debilitating symptoms similar to those you’d have if you were having a heart attack. Continue reading “His and hers heart disease”