When the heart’s smallest vessels cause big problems

Ongoing studies seek new ways to treat microvascular disease, which can be tricky to diagnose.

Three main arteries, each no bigger than a strand of thin spaghetti, stretch across the surface of your heart. Each branches into progressively smaller and smaller vessels that eventually penetrate your heart muscle. Damage to these tiny vessels can diminish blood flow to the heart—a condition known as coronary microvascular disease.

The symptoms include chest pain or shortness of breath, as well as diffuse chest discomfort or unusual exhaustion. Sound familiar? These symptoms are similar and often just as debilitating as those from classic coronary artery disease, which results from a buildup of cholesterol-laden plaque inside the heart's larger vessels. But unlike that more common manifestation of heart disease, microvascular disease is much more difficult to diagnose.