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Published on: August 17, 2022
The danger of underdiagnosing coronary microvascular disease in women
1School of Nursing, University of Michigan-Flint, Michigan.
Insights
Coronary microvascular disease (CMVD) is a major cause of heart disease in women, often missed due to nonobstructive blockages. Early diagnosis and treatment are crucial for preventing adverse cardiac events in these patients.
Area of Science:
- Cardiology
- Women's Health
Background:
- Heart disease is the leading cause of death for women in the U.S.
- Coronary microvascular disease (CMVD), or nonobstructive coronary artery disease, presents diagnostic challenges.
- CMVD often lacks clear evidence of acute issues, leading to missed diagnoses.
Purpose of the Study:
- To provide clinicians with information to diagnose and treat CMVD in women.
- To highlight the difficulties in diagnosing CMVD when epicardial arteries show no blockages.
Main Methods:
- Review of diagnostic challenges in CMVD.
- Discussion of typical patient presentation with normal stress tests.
- Emphasis on symptom management as a diagnostic clue.
Main Results:
- CMVD is frequently undiagnosed due to lack of visible blockages and normal stress tests.
- Symptomatic patients with CMVD are at risk of adverse cardiac events.
- Treatment of symptoms is often the primary diagnostic pathway.
Conclusions:
- Advanced practice nurses and clinicians need specific guidance for diagnosing and treating CMVD.
- Recognizing CMVD is critical for improving cardiac event outcomes in women.
- Further research into diagnostic methods for CMVD is warranted.
Abstract:
Heart disease is the number one killer of women in the United States. Part of the difficulty with diagnosing heart disease in women is related to a disease process called coronary microvascular disease (CMVD; previously called syndrome X). Also known as nonobstructive coronary artery disease, CMVD is challenging to identify because often there is a lack of convincing evidence of an acute problem during evaluation. In these patients, the epicardial coronary arteries do not have visible blockages, and stress tests often are interpreted as normal or false positive. Therefore, symptomatic patients often are left undiagnosed, frustrated, and at risk of adverse cardiac events. Frequently, the only method of diagnosis is treatment of the symptoms. This information is provided to help advanced practice nurses and other clinicians diagnose and treat CMVD.
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