coronary microvascular disease
Dysfunction of small coronary arteries causing angina symptoms despite normal epicardial coronary arteries.
Full Definition
Coronary microvascular disease (CMD) refers to structural and functional abnormalities of the coronary microvasculature that result in impaired coronary flow regulation and myocardial ischemia despite the absence of significant epicardial coronary artery stenosis. CMD can manifest as reduced coronary flow reserve, increased coronary microvascular resistance, or enhanced vasoconstrictor responses. Patients typically present with angina symptoms and may have positive stress tests, but coronary angiography shows normal or near-normal epicardial arteries. CMD is more common in women and is increasingly recognized as an important cause of ischemic heart disease requiring specific diagnostic and therapeutic approaches.
Usage
Usage note: Often abbreviated as CMD; distinguish from epicardial coronary artery disease in documentation.
In Context
- "Despite normal coronary arteries, the patient's symptoms were consistent with coronary microvascular disease." — cardiology consultation
- "Coronary microvascular disease should be considered in women with angina and normal angiography." — clinical practice guideline