coronary microvascular dysfunction
Pronunciation: see-em-dee
Also written as: CMD — coronary microvascular dysfunction
Impaired function of small coronary vessels (<500 μm) that cannot be visualized on conventional angiography, causing ischemia despite normal epicardial arteries.
Full Definition
A pathophysiological condition affecting the coronary microvasculature - arterioles, capillaries, and venules smaller than 500 micrometers in diameter - that leads to impaired coronary blood flow reserve and myocardial ischemia in the absence of obstructive epicardial coronary artery disease. This condition can be assessed through various techniques including coronary flow reserve measurement, index of microcirculatory resistance, and positron emission tomography perfusion imaging. Coronary microvascular dysfunction is increasingly recognized as an important cause of angina, particularly in women, and may contribute to adverse outcomes including heart failure development and increased cardiovascular mortality despite angiographically normal coronary arteries.
Usage
Usage note: Emerging area of interest; distinguish clearly from epicardial coronary artery disease.
In Context
- "Coronary microvascular dysfunction was assessed using adenosine-stress cardiac MRI in patients with chest pain and normal angiograms." — Diagnostic methodology
- "The prevalence of coronary microvascular dysfunction was significantly higher in the diabetes mellitus group (67% vs. 23%, p<0.001)." — Research findings