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Treatments and drugs
By Mayo Clinic staffThe treatment for small vessel disease involves medications to control the narrowing of your small blood vessels that could lead to a heart attack. Your doctor could prescribe:
- Nitroglycerin. Nitroglycerin tablets, sprays and patches can ease chest pain by opening up your coronary arteries and reducing your heart's demand for blood.
- Ranolazine (Ranexa). This medication eases chest pain by altering sodium and calcium levels.
- Beta blockers. These drugs slow your heart rate and decrease your blood pressure, which decreases your heart's demand for oxygen-rich blood.
- Calcium channel blockers. These medications relax the muscles that surround your coronary arteries and cause the vessels to open, increasing blood flow to your heart. They also control high blood pressure.
- Statins. These medications help lower cholesterol, which contributes to the narrowing of your arteries. Statins also help relax the blood vessels of your heart and treat blood vessel damage.
- Angiotensin-converting enzyme (ACE) inhibitors. These medications help open your blood vessels, making it easier for blood to flow through, lowering your blood pressure and decreasing your risk of a heart attack.
- Angiotensin II receptor blockers (ARBs). These medications relax your blood vessels, which lowers your blood pressure and makes it easier for your heart to pump blood.
- Aspirin. Aspirin can help limit inflammation and prevent blood clots from forming.
Because the blocked or narrowed blood vessels that cause the disease are so small, surgery is usually not a treatment option. If you're diagnosed with small vessel disease, you'll need to see your doctor regularly for checkups. Your doctor will determine how often you'll need to be examined, depending on the severity of your condition.
References
- Bairey Merz CN, et al. Syndrome X and microvascular coronary dysfunction. Circulation. 2011;124:1477.
- What is coronary microvascular disease? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/cmd/cmd_all.html. Accessed March 5, 2013.
- Camici PC, et al. Coronary microvascular dysfunction. New England Journal of Medicine. 2007;356:830.
- Lanza GA, et al. Primary coronary microvascular dysfunction: Clinical presentation, pathophysiology, and management. Circulation. 2010;121:2317.
- Cholesterol. Mayo Medical Laboratories. http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/8320. Accessed March 5, 2013.
- Topcu S, et al. Metformin therapy improves coronary microvascular function in patients with polycystic ovary syndrome and insulin resistance. Clinical Endocrinology. 2006;65:75.
- Kothawade K, et al. Microvascular coronary dysfunction in women-pathophysiology, diagnosis, and management. Current Problems in Cardiology. 2011;36:291.
- Littarru GP, et al. Clinical aspects of coenzyme Q10: An update. Nutrition. 2010;26:250.
- Gao L, et al. Effects of coenzyme Q10 on vascular endothelial function in humans: A meta-analysis of randomized controlled trials. Atherosclerosis. 2012;221:311.
- Teede HJ, et al. Endothelial function and insulin resistance in polycystic ovary syndrome: the effects of medical therapy. Fertility and Sterility. 2010; 93:184.
- EndoPat overview. Endopat.com. http://endopat.com/Home_Page.html. Accessed March 19, 2013.
- Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. March 18, 2013.
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