Treatment for Coronary Microvascular Disease or Small Vessel Heart Disease & Its Prevention, Coping, Exercises

So far there are no studies to suggest any particular methods to prevent coronary microvascular disease or small vessel heart disease. Coronary microvascular disease and coronary heart disease share the common symptoms and the researchers are still trying to find ways which can prevent particularly coronary microvascular disease. This part of the article deals about the treatment, alternative therapy, coping, exercises, prevention and lifestyle changes.

The doctor would treat the patients of coronary microvascular disease or small vessel heart disease by trying to provide medications to broaden the small blood vessels to prevent any chances of heart attack. Here are some of the prescriptions:

• Nitroglycerin medicine for coronary microvascular disease or small vessel heart disease. Nitroglycerin tablets, sprays and patches are very effective in relieving chest pain by ensuring proper supply of blood to heart and opening up your coronary arteries.
• Ranolazine (Ranexa) for treating coronary microvascular disease or small vessel heart disease. This medication relieves chest pain by altering calcium and sodium levels.
• Beta blockers for treating coronary microvascular disease or small vessel heart disease. These drugs reduce the chances of heart attack by causing the heart rate to slow down which reduces the blood pressure reducing the demand of oxygenated blood by heart.
• Calcium channel blocker prescriptions for coronary microvascular disease or small vessel heart disease. These medications help in opening of small vessels by relaxing the muscles on its surrounding. This ensures proper supply of blood to heart and controlling high blood pressure.
• Statin medicines for treating coronary microvascular disease or small vessel heart disease. Statins cuts down the cholesterol level in blood which is the major cause of narrowing of blood vessels. They also help in relaxing blood vessels and checks damage to blood vessels.
• Angiotensin-converting enzyme (ACE) inhibitors. They cause the blood vessels to open ensuring proper flow of blood and reducing the chances of high blood pressure and heart attack.
• Angiotensin II receptor blockers (ARBs) pills for coronary microvascular disease or small vessel heart disease. They help in relaxing blood vessels and ensuring proper blood pressure and proper functioning of heart.
• Aspirin remedy for coronary microvascular disease or small vessel heart disease. Aspirin prevents formation of blood clots and reduces chances of inflammation.

Surgery is usually not recommended for the treatment of coronary microvascular disease or small vessel heart disease as the blood vessels are very small. Medication is commonly preferred for the treatment and doctor perform regular checkups to ensure that the problem is under control. The frequency of checkups and medication will depend on the severity of the disease.

Doctors also recommend some dietary supplements for the treatment of coronary microvascular disease or small vessel heart disease like:

• Coenzyme Q10. It is a type of coenzyme which is present in found in our body naturally and ensures proper blood circulation and pressure. It can be taken as supplement in a dose of 200 mg per day to ensure proper flow of blood through vessels in case of patients of diabetes and coronary microvascular disease or small vessel heart disease. Thus it can be used to cure small vessel disease.
• L-arginine. It is a type of amino acid which helps in metabolism of protein and can also help in relieving the symptoms of coronary microvascular disease or small vessel heart disease. However the patients who have had heart attack earlier cannot take this therapy.

It is always recommended to refer to your doctor before taking any other medication or supplement in addition to the list above to make sure it is safe.

Coping and living with coronary microvascular disease or small vessel heart disease is challenging. If you are diagnosed with coronary microvascular disease or small vessel heart disease, visit your doctor regularly to get it checked. Check for your blood pressure, blood sugar and cholesterol levels under control to help your doctor in proper treatment.

It is strongly recommended that you refer to a cardiologist (heart specialist) along with your primary doctor. Go for regular blood checkups as advised by your doctor and report any new symptoms immediately as they occur and before they get worse. You should:

• Know and understand the limits of your physical activity. Do not push yourself too hard.
• Know which medicines you take and when and how to take them.
• Know your symptoms and how and when to seek medical help.
• Know how to control your symptoms, including angina.
• Learn ways like yoga pranayam breathing exercises to avoid or cope with mental stress and anxiety.
• Be able to describe the usual pattern of your symptoms.

The patients of coronary microvascular disease or small vessel heart disease must be aware of the warning indications of a heart attack in order to properly cope with the illness. Some of the common signs and indications of heart attack are as follows:

• Pain in chest or discomfort could be a sign of heart attack. It includes squeezing, fullness, uncomfortable pressure, or ache in the left side or center of patients’ chest that can be strong or mild. The situation can persist for longer than 3 to 5 minutes and would repeat itself.
• Upper body discomfort in the back, jaw, one/both of the arms, neck, or upper region of the patients’ stomach.
• Breath shortness, which might happen with or even before beginning of discomfort in the chest.
• Nausea, fainting or light-headedness, vomiting, or begin in a cold sweat.
• Fatigue (tiredness), sleep problems, and loss of strength.

In case of a heart attack, call for emergency by dialing 911 immediately as any delay can be fatal and life threatening. Never try to reach a hospital by driving on your own or with the help of someone. Instead call ambulance as you can get lifesaving treatment immediately in ambulance even before reaching to hospital.

Keep your friends and neighbors informed about your heart problem as they can run for your help in case of any emergency by understanding the symptoms and can save your life.

The recovery period/healing time for coronary microvascular disease or small vessel heart disease depends on various parameters like mode of treatment and thus a fixed recovery time cannot be stated. For an exact recovery time in your case, it is best to consult your doctor and get your any other queries answered.

Regular exercise can play an essential role in preventing coronary microvascular disease or small vessel heart disease which is a type of heart disease which upsets the small coronary (heart) arteries. Coronary microvascular disease or small vessel heart disease is caused by the blockage of the walls of the heart’s small arteries due to any type of disease or damage.

Regularly exercise is the key for the patients of heart diseases to keep things under control or recover from a heart surgery. Consult your doctor about the following before going ahead with exercises:

• It is good to ask your doctor about the list of activities that you can include in your routine safely to avoid any dilemma.
• Talk about the set of exercises that you can follow especially sit-ups and pushups as they put extra stress on your muscles and may not be safe for you when you have coronary microvascular disease or small vessel heart disease.
• Some exercises like pushing heavy objects and heavy lifting, and chores such as shoveling, raking, scrubbing, and mowing can get you tired very quickly. Consult your doctor before performing.
• Medication changes. There are some drugs that can get you more rewards out of your exercise. Thus inform your doctor about your exercise plan so that he can make necessary changes in your medication if required.

Here are some of the tips related to workouts for the patients with coronary microvascular disease or small vessel heart disease:

• Pace yourself. Do not rush with your exercises after you have suffered with coronary microvascular disease or small vessel heart disease. Build up gradually and give proper time to your body to relax between exercises.
• Do not exercise outside when it is humid hot or cold. Avoid exercising in some extreme conditions like high temperature as it may affect your blood circulation and lead to difficulties in breathing and pain in chest. Humid weather can suck more energy and leave you tired. Thus it is best to avoid such situations by exercising indoors in such weather conditions if you had coronary microvascular disease or small vessel heart disease.
• Continue to be hydrated. Drink lots of water and keep yourself well hydrated especially in summer season.
• Avoid extremely cold and hot showers or even sauna baths post workouts. High temperature can compel your heart to beat faster and thus it must be avoided.
• Do not exercise in hilly regions. Avoid climbing steep slopes and make sure to go slow while climbing hill to keep your heart beat normal. Keep a check on your heartbeat and know the safe limit by consulting with your doctor.

If you are unable to continue your exercise for some days because of some vacation, bad weather or illness, restart by pushing yourself slowly and gradually towards the routine instead of starting with complete set of exercises.

If you are unable to handle exercises and getting tired or fatigued too quickly, see your personal doctor and explain your situation to seek solution.

It is strongly recommended to stay away from exercise if you are having fever and get back to the exercise plan only after full recovery from coronary microvascular disease or small vessel heart disease and recommendation of your doctor.

The physical activity must be immediately terminated in case of irregular heartbeat or heart palpitations. Relax for some 15 minutes or so and then check for your heart beat. If they continue to show readings of 100-120 beats per minute, you must seek help from your doctor immediately.

If you start to have chest pain or any other pain while exercising, the physical activity must be stopped immediately as it can damage your joints severely. Avoid exercising when you:

• Feel weakness in your body.
• Are concerned for any reason.
• Feel light-headed or dizzy.
• Feel pressure or pain in your chest, neck, arm, jaw, or shoulder.
• Have unexplained swelling, call the doctor right away.

In case of any of the above symptoms of coronary microvascular disease or small vessel heart disease, get in touch with your doctor or call ambulance.

So far there are no researches to guide us towards the prevention plan of coronary microvascular disease or small vessel heart disease but by keeping a check on certain parameters like obesity, high cholesterol, blood pressure etc… can surely help. Here are some of the things that can help with prevention of coronary microvascular disease or small vessel heart disease:

• Do not smoke or use other tobacco products to put an end to coronary microvascular disease or small vessel heart disease. Smoking is highly injurious to health and especially heart. Similarly, use of tobacco and related products can damage your heart and try to quit smoking and taking tobacco. Seek help of your doctor in case of any difficulty. If you smoke, the most important thing you can do to improve your heart’s health is to stop.
• Eat a heart healthy diet to prohibit coronary microvascular disease or small vessel heart disease. Prepare a healthy diet plan for yourself with the help of doctor or dietician which is low in saturated fat and cholesterol and rich in whole grains, low-fat dairy, lean meat, and fruits and vegetables to prevent the occurrence of heart diseases.
• Watch for the intake of fat and salt in your diet as excessive salt and fat can also raise the level of cholesterol and blood pressure.
• Exercise regularly to counter coronary microvascular disease or small vessel heart disease. Exercising on a regular basis is very good for health, especially heart patients. It keeps the heart healthy and maintains proper flow of blood through the arteries. It keeps your body weight in control and thus minimizes the chances of heart attack and keeps diabetes, blood pressure and cholesterol in control. The best way to exercise is to go slow and steady and follow it regularly.
• Check your cholesterol in order to limit coronary microvascular disease or small vessel heart disease. Check for the level of cholesterol in your blood stream to make sure that bad cholesterol is below the prescribed safety limits. If it exceed safe limit, consult your doctor from proper medication to protect yourself from small vessel disease.
• Control your blood pressure to prevent coronary microvascular disease or small vessel heart disease. The patients of high blood pressure or those having family history of heart problems must pay special attention to blood pressure and get it checked regularly as per the recommendation of doctor.
• Maintain a healthy weight to prevent coronary microvascular disease or small vessel heart disease. Extra weight can give rise to many problems like high cholesterol, high blood pressure and diabetes which affect your heart directly. Thus keep your weight in control and stay free from the risk of small vessel disease.
• Manage stress to ward off coronary microvascular disease or small vessel heart disease. Avoid stress in your routine as it may cause heart attack. Reconsider your workaholic activities and to find some recommended and safe habits to keep your healthy and free from stress and heart attack.
• Control blood sugar levels if you have diabetes to prevent coronary microvascular disease or small vessel heart disease. The patients of diabetes must pay special attention to sugar levels to minimize the chances of any type of heart disease. Ask your doctor to set proper limits for your blood sugar levels and ways to achieve it and keeping your heart safe.
• If you have POS or polycystic ovary syndrome, ask your doctor if metformin could help in restraining coronary microvascular disease or small vessel heart disease. The use of metformin (Glucophage, Glumetza) for reducing insulin resistance puts the women with polycystic ovary syndrome in reduced risk of coronary microvascular disease or small vessel heart disease in women.

There are many risk factors that cannot be avoided like older age and family history but other factors like obesity, high blood cholesterol, smoking, high blood pressure, diabetes and overweight can be taken care to reduce the risk of coronary microvascular disease by making necessary changes in lifestyle and following a prescribed medical plan.

The following things must be included in a heart healthy life style to minimize the chances of coronary microvascular disease or small vessel heart disease:

1. Heart Healthy Food for Coronary Microvascular Disease or Small Vessel Heart Disease

   Doctors recommend the following food items embedded in your lifestyle to keep the heart healthy:

   • Legumes, such as lentils, kidney beans, black-eyed peas, chickpeas & lima beans.
   • Dairy products with low fat content, like the usage of skim milk.
   • Whole grains, such as brown rice, oatmeal & corn tortillas.
   • Fish with high in omega 3 fatty acids like tuna, salmon, trout.
   • Fruits like bananas, pears, apples, prunes & oranges.
   • Vegetables like carrots cabbage and broccoli should be consumed to prevent coronary microvascular disease or small vessel heart disease.

   Following food items must be avoided in heart healthy lifestyle:

   • Palm and coconut oils.
   • Excess consumption of red meat.
   • Beverages and sugary foods.

   Sodium Intake for Patients with Coronary Microvascular Disease or Small Vessel Heart Disease

   The amount of the sodium in the diet must be limited by using less sodium and salt in food preparation. The food with low amounts of sodium and no addition of salt must be used. The labels on the food items can tell you about the level of sodium in the food. The maximum amount of sodium in a day restricted to 2300 mg. The patients with coronary microvascular disease or small vessel heart disease and of high B.P (blood pressure) must use even lower level of sodium.

   Dietary Ways to Prevent Hypertension in Coronary Microvascular Disease or Small Vessel Heart Disease

   Doctors recommend Dietary Approaches to Stop Hypertension (DASH) food plan for the patients of high B.P (blood pressure). The Dietary Approaches to Stop Hypertension food plan includes whole grains, vegetables, fruits, and alternative foods which are healthy to heart and low in cholesterol, fat, and sodium & salt. It is very healthy plan which can be followed by everyone to keep the heart healthy.

   Alcohol intake in Coronary Microvascular Disease or Small Vessel Heart Disease

   The intake of alcohol must be limited if not avoided in patients with coronary microvascular disease or small vessel heart disease. Excessive intake of alcohol can increase the levels of blood pressure (B.P) & triglyceride. Triglyceride is one of the fats found in the blood. Intake of alcohol can lead to weight gain as it high in calories. In case of men, the amount of alcohol should be limited to maximum two drinks per day and for women it should be one drink per day. Cone drink refers to:

   • One and half ounces of liquor.
   • Five ounces of wine.
   • Twelve ounces of beer.

2. Managing a Healthy Weight in Coronary Microvascular Disease or Small Vessel Heart Disease

   It is always good to manage proper body weight and it also minimizes the risk of coronary microvascular disease or small vessel heart disease. Proper weight can be maintained by following a lifestyle change of healthy diet plan and exercising regularly.

   Body Mass Index (BMI) is a good way to estimate the right weight for you and gives you an idea of the total fat in body. For BMI, you can refer to National Heart, Lung, and Blood Institute’s (NHLBI) online BMI calculator or consult your doctor. A BMI:

   • Amid 18.5 & 24.9 is normal.
   • Amid 25 and 30 is advised as overweight.
   • Below 18.5 is a sign that you are underweight.
   • BMI of thirty or higher is advised as obese.

   Thus BMI lower than twenty five is perfect and you can refer your doctor for a proper diet plan to achieve your goal.

   The circumference of the waist is a good measure of health risks. It is better to have fat around the hips as compared to having it around the waist as it increases the risk of heart diseases & diabetes of type 2. Waist size should not be more than forty inches for men and 35 inches for women.

   If a person is overweight, he must make effort to reduce weight. Even a reduction of 3-5% of the weight can reduce the risk of developing diabetes of type 2, blood glucose and triglycerides. Further loss of weight can help in reducing high blood pressure, lowering LDL (Low-density lipoprotein) cholesterol and increasing HDL (High-density lipoprotein) cholesterol.

3. Managing Chronic Stress in Coronary Microvascular Disease or Small Vessel Heart Disease

   Chronic stress can cause coronary microvascular disease or small vessel heart disease. It is proved by researches that the most common cause of heart attack is the emotional upset especially driven by anger. Trying to cope up with stress by drinking, smoking or overeating is not the right way to go and can further affect health adversely. It is good to know right ways to manage your stress, and overcome emotional and physical health problems. By making changes in lifestyle and adapting the following activities can help reduce the stress:

   • Talking with family or friends.
   • Meditation.
   • Relaxation therapy.
   • Physical activity.
   • Taking stress management program.

4. Physical Activity for Coronary Microvascular Disease or Small Vessel Heart Disease

   Regular physical activities is a good lifestyle change and it also reduces the risk of coronary microvascular disease or small vessel heart disease by lowering high blood pressure, LDL (“bad”) cholesterol, & over weight. It further reduces the risk of diabetes and boosts the level of HDL (good) cholesterol and keeps you away from coronary heart disease.

   Stick to a proper physical activity plan and make sure you engage yourself for a minimum of 2 and a half hour in medium severity aerobic workout every week or follow a vigorous aerobic exercise for at least one hour & 15 minutes/ week. Any type of aerobic exercise like brisk walking which can get your heart pumping faster and increase oxygen demand can reduce the risk of heart diseases. Follow an aerobic activity like swimming for at least ten minutes every day for the whole week. Consult your primary care doctor before following any fresh exercise plan to ensure that it is secure for you and suits your routine.

5. Ongoing Medical Care for Coronary Microvascular Disease or Small Vessel Heart Disease

   Make yourself more aware and gather information about conditions, traits and habits that can push you towards heart diseases such as coronary microvascular disease or small vessel heart disease. Consult your doctor about the risk factors and seek advice to control them.

   In some cases, the changes in lifestyle may not solve the problem completely (but they will surely help in long term). You might have to take medicines as per your doctor’s prescription. Remain in touch of your doctor and go through the recommended tests.

   See your reports and know about the parameters with help of your doctor. Know about the following results:

   • Fasting blood glucose. This test is for diabetes.
   • Lipoprotein panel. This test measures total cholesterol, LDL (Low-density lipoprotein) (“bad”) cholesterol, HDL (“good”) cholesterol, and triglycerides (a type of fat in the blood).
   • Blood pressure measurement.

   Be aware of any family history related to coronary microvascular disease or small vessel heart disease and in case you find one, share it with your doctor.

Also Read:

• Coronary Microvascular Disease or Small Vessel Heart Disease: Causes, Symptoms, Diagnosis, Risk Factors, Complications