Compared to the conventional knowledge of angina, microvascular is more of a recent one. If you imagine your main Coronary arteries coming onto the surface of your heart, e.g, Left anterior descending, left circumflex, right coronary artery, they gradually branch out and become smaller, like all arteries. Picture the roots on a plant, it's the same. You start with the main stem, then getting smaller and smaller, you end up with hair size roots. Arteries are the same. They branch through your tissue until they become very small arteries (arterioles) and these connect to capillaries. The capillaries are the virtually microscopic vessels which deliver oxygen to your cells, and remove carbon dioxide. So in essence, those large arteries we started with are there to supply all the capillaries. If large arteries become blocked, we stent or bypass them because they are large enough for tools to do the job. However, with much smaller arteries it's more difficult. When you get down to arerioles, it really is impossible. It would be like having a tube the thickness of a hair and trying to use a pipe cleaner in it. When these tiny vessels get blocked, or restricted from disease, this is microvascular disease.
I believe the only current help with MVD is using medications to help keep the heart relaxed more. Using statins to reduce cholesterol, and using slow release nitrates to keep the vessels dilated. More research is ongoing with this disease.
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