• Coronary microvascular disease (MVD) affects the heart's smallest coronary arteries, called arterioles.

• Coronary MVD is more common in women than in men.

• Heart disease, in general, is a different disease for women than it is for men.
 
• Signs and symptoms of coronary MVD often differ from those of traditional coronary artery disease (CAD). Typical signs and symptoms of CAD include angina (chest pain), feeling pressure or squeezing in the chest, shortness of breath, excessive sweating, and arm or shoulder pain. Women with coronary MVD may also have shortness of breath, sleep problems, fatigue (tiredness), and lack of energy.  Symptoms are often first noticed during routine daily activities and times of mental stress.

• Coronary MVD occurs when plaque forms in the arteries, when the arteries spasm (tighten), or when the walls of the arteries are diseased or damaged, preventing enough oxygen-rich blood from getting to the heart muscle.

• In coronary MVD, plaque doesn't always lead to blockages as it does in traditional coronary artery disease (CAD). For this reason, coronary MVD is called non-obstructive CAD.

• Women with chest pain and other heart symptoms are more likely than men to have clear coronary arteries when diagnostic tests are performed.

• The same cluster of risk factors that cause CAD may cause coronary MVD. These include unhealthy cholesterol levels, high blood pressure, smoking, insulin resistance, diabetes, overweight and obesity, lack of physical activity, age, and family history of early heart disease.
 
• Coronary MVD is difficult to diagnose. Your doctor may start with a questionnaire called the Duke Activity Status Index, which measures how well you're able to do your daily activities.  Other tests include pharmacological stress testing and a special type of coronary angiogram used to measure coronary artery flow reserve.

• If you have coronary MVD, you can take steps to stop it from getting worse. These may include lifestyle changes, medicines, and regular medical care.