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Your Chest Pain May Be a Sign of This Lesser-Known Condition — Not a Heart Attack


When it comes to heart attacks, you’ve probably heard that chest pain may be an early sign that something’s wrong. However, scientists have found that an increasing number of women may not be on the verge of a heart attack or experiencing one in real time when they feel discomfort in their chests. It may instead of a little-known condition called coronary microvascular dysfunction, which is often misdiagnosed in favor of other heart issues.

What is coronary microvascular dysfunction?

Coronary microvascular dysfunction (CMD) is a heart condition where the walls and linings of smaller coronary artery blood vessels carry less and less blood from larger coronary arteries. Coronary arteries are responsible for bringing oxygenated blood to the entire heart muscle, which keeps it pumping and moving efficiently. So when these tiny blood vessels aren’t carrying as much blood, the heart isn’t getting the oxygen it needs to work properly. This, in turn, causes a wide range of health problems.

Because these blockages are often located in smaller arteries, doctors may miss them altogether or mistake them for heart attacks, which typically occur it the larger coronary arteries. Due to the high misdiagnosis rate and CMD’s status as newly researched conditions, scientists aren’t even sure how many people may have it.

Additionally, women — especially older women — are more likely to develop CMD than men due to their lower estrogen levels, which continue to decrease during menopause. Plus, unlike a heart attack, which can happen suddenly, CMD can slowly worsen for years or even decades before it leads to a larger heart incident, which only adds to the number of misdiagnoses.

What causes CMD, and what are the symptoms?

Researchers still don’t know a lot about CMD, but they believe it can be caused by a variety of factors, including high blood pressure, smoking, diabetes, obesity, unhealthy cholesterol levels, an unhealthy diet, lack of exercise, genetics, and more.

Only adding to the confusion, CMD’s symptoms can make the condition look a lot like a heart attack. People with CMD may experience chest pain, shortness of breath, fatigue, and insomnia.

What are treatment CMD options, and how can you prevent it?

Getting a diagnosis may require a number of tests, including an exercise stress test, coronary angiography, and coronary magnetic resonance imaging, in addition to a Duke Activity Status Index, which is a questionnaire about your daily activities and how they affect your symptoms.

The good news is that preventing CMD looks very similar to preventing other heart conditions. This includes quitting smoking if it’s a habit for you, exercising regularly, managing your weight, maintaining a healthy diet, reducing your stress levels, and controlling your blood pressure.

There are, however, additional prescriptions that a doctor might give to you in order to help manage CMD, like nitroglycerin to open up your arteries, beta-blockers or calcium channel blockers to help the heart rest, and isosorbide to prevent further chest pain or distress. Your doctor may also give you additional medications to manage some of the other symptoms, such as high blood pressure or cholesterol, but that’ll depend on your specific case.

The next time you head to the doctor, it may be worth asking about coronary microvascular dysfunction to see if you it could be causing your underlying discomfort and pain. It could end up getting you an answer sooner rather than later!

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