Small vessel disease (SVD) is a serious medical condition that affects the function of the coronary arteries and puts heart health at risk. It is usually detected in the presence of arterial constriction and can be caused by several factors. Treatment focuses on slowing the progression of arterial narrowing and improving blood flow with medication and supplements. Diagnostic tests include imaging, EKG, and endothelial dysfunction tests. Lifestyle factors such as smoking, obesity, and a high-cholesterol diet can increase the risk of SVD.
Small vessel disease (SVD) is a serious medical condition that negatively affects the function of the coronary arteries and puts heart health at risk. Frequently associated with the onset of atherosclerosis, SVD affects an artery’s ability to expand to accommodate proper blood flow. The condition is usually detected in the presence of a more pronounced arterial constriction as occurs with atherosclerosis. Treatment for SVD focuses on slowing the progression of arterial narrowing and improving blood flow with the use of medications and supplements.
With normal cardiovascular function, the small blood vessels within the heart work together with the main coronary arteries to circulate oxygenated blood throughout the body. Small blood vessels are designed to expand or contract based on your activity level to accommodate proper blood flow. Similar to atherosclerosis in its presentation, small vessel disease manifests as a constriction of small blood vessels that impairs blood flow, impairing circulation and heart function. Several factors can contribute to the constriction of small blood vessels and the development of small vessel disease, including plaque buildup, clot formation, and aneurysms.
Endothelial dysfunction often occurs in the presence of SVD, further impairing blood vessel expansion during periods of physical activity which may also contribute to further vessel damage and constriction. The development of additional contributing factors in the presence of SVD places the cardiovascular system at significant risk for oxygen deprivation and permanent damage or dysfunction. Individuals with small vessel disease often experience a variety of signs and symptoms that commonly progress in presentation and severity.
Those with SVD more often develop chest pain, also known as angina, which can manifest as a feeling of tightness within the chest area; sometimes central on the left side. Others may experience symptoms that include shortness of breath, pronounced fatigue, or sweating profusely. Sometimes, symptoms of SVD can present similar to those associated with the flu, such as nausea, vomiting, and sensations of localized pain or discomfort in the upper trunk and neck.
There are several diagnostic tests that can be done to confirm a diagnosis of small vessel disease. Individuals may undergo a variety of imaging tests that may include computed tomography (CT) angiography, positron emission tomography (PET), and magnetic resonance imaging (MRI) to evaluate the condition of the heart muscle, blood flow, and any existing arterial blocks. An electrocardiogram (EKG) may also be done to evaluate the electrical activity of the heart in order to detect any abnormalities indicative of impaired blood flow or arterial blockage. Additionally, an endothelial dysfunction test may be ordered to evaluate and measure arterial blood flow.
Treatment for small vessel disease generally focuses on reducing arterial constriction, improving blood flow, and decreasing the chances of a heart attack or other cardiovascular problems. Statins, angiotensin converting enzyme (ACE) inhibitors, and angiotensin II receptor blockers (ARBs) are commonly prescribed to treat SVD-induced arterial narrowing, prevent further arterial damage, and regulate blood pressure. Additionally, individuals may be placed on a regimen of aspirin to prevent clotting reducing the risk of heart attack and supplemental amino acids to ease discomfort related to SVD symptoms.
If symptoms are ignored and SVD remains undiagnosed, arterial constriction can worsen, putting extra stress on the heart and forcing it to work harder. The added stress, coupled with insufficient circulation of oxygenated blood, increases the risk of cardiovascular complications, such as heart attack and heart failure. Several behavioral and lifestyle factors can also increase the risk of developing small vessel disease, including smoking, obesity, and regular consumption of a high-cholesterol diet. Those who have been diagnosed with certain medical conditions, such as rheumatoid arthritis and diabetes, may be at higher risk for SVD. Individuals can reduce the risk of small vessel disease by pursuing a healthy lifestyle that includes maintaining a healthy body weight, consuming a balanced diet, and abstaining from risky behaviors, such as smoking and excessive alcohol consumption .
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