Coronary microvascular dysfunction (CMD) makes your heart's blood vessels not work the way they should. Instead of opening wide when your heart needs oxygen, like during exercise, they stay closed and narrow. That means the heart doesn’t receive as much blood as it needs.
CMD causes symptoms like:
- Chest pressure or discomfort
- Shortness of breath
- Unexplained fatigue
A Focus on CMD Treatment for Women
CMD is a serious heart condition that affects women more than men. This is especially true in people with lower estrogen levels (which happens around menopause). It's a leading cause of chest pain in women. Having CMD increases your risk for heart disease and heart attack.
At UVA Health, our Women's Heart Care Program has deep expertise in treating heart issues in women. This dedicated focus allows us to find and treat heart problems that sometimes get overlooked or untreated.
Getting a CMD Diagnosis
Because the affected blood vessels are so tiny, CMD doesn’t show up on most routine imaging tests.
For this reason, CMD is often missed or misdiagnosed. That’s why advanced imaging and expert knowledge of the condition are critical.
At UVA Health, we offer advanced testing to get an accurate diagnosis. Our assessments go beyond standard testing. We combine a review of sex-specific risk factors with advanced imaging that includes heart-specific MRI and PET scans.
CMD Treatment at UVA Health
Getting holistic treatment for your CMD means a better experience and long-term wellness. We have an approach that includes:
- Nutrition
- Mental health
- Exercise
- Medications
You not only get expert medical attention. As a patient, you get access to an entire team dedicated to your heart health. You'll have dietitians, exercise physiologists, psychologists, social workers, and pharmacists to support you.
In addition, we lead clinical trials and National Institutes of Health-funded research to explore novel therapies. We aim to deliver even more personalized and effective treatment options for CMD.
Tiny Blood Vessels, Big Heart Problem
"CMD is often misclassified," says Patricia Rodriguez-Lozano, MD, CMD expert and director of the Women’s Heart Health Care program at UVA Health.
What Causes CMD?
Factors that contribute to CMD include:
- A problem with the blood vessel lining, or endothelium
- Vessels that become stiff or narrow because of inflammation or stress
- Hormonal changes, especially around menopause or after pregnancy
- An overactive stress response or nervous system signals
CMD tends to worsen with emotional or mental stress.
Other risk factors for CMD include:
- An unhealthy diet
- Diabetes
- High blood pressure
- High cholesterol
- Lack of physical activity
- Low estrogen levels
- Older age, especially in women who are postmenopausal
- Overweight and obesity
- Smoking