coronary microvascular dysfunction
Impaired function of coronary arterioles and capillaries causing ischemia without obstructive epicardial disease.
Full Definition
Coronary microvascular dysfunction (CMD) encompasses structural and functional abnormalities of coronary arterioles and capillaries that can cause myocardial ischemia in the absence of obstructive epicardial coronary artery disease. CMD may result from endothelial dysfunction, smooth muscle abnormalities, increased vasomotor tone, or structural remodeling of the microvasculature. Patients often present with anginal symptoms despite normal coronary angiograms, a condition sometimes termed 'cardiac syndrome X.' Diagnosis requires specialized testing including coronary flow reserve assessment, acetylcholine provocation, or thermodilution-based measurements. CMD is particularly common in women and patients with diabetes, hypertension, or heart failure with preserved ejection fraction.
Usage
Usage note: CMD abbreviation acceptable after first use; distinguish from epicardial coronary artery disease.
In Context
- "Despite normal coronary angiography, coronary microvascular dysfunction was suspected based on reduced coronary flow reserve." — Cardiac catheterization report
- "The patient's persistent angina was attributed to coronary microvascular dysfunction rather than epicardial disease." — Clinical assessment summary