Vascular Medicine Conference-CVC 2026

Coronary Microvascular Disease (CMD) presents a unique clinical challenge, distinct from classic obstructive coronary artery disease. Rather than involving significant blockages in the large coronary arteries, CMD affects the smaller coronary vessels responsible for perfusing the heart muscle. Dysfunction or narrowing in these microvessels can precipitate symptoms such as microvascular angina (chest pain), dyspnea, fatigue, and diminished exercise capacity.

CMD is typically associated with well-established cardiovascular risk factors, including diabetes mellitus, hypertension, obesity, tobacco use, and metabolic syndrome. Early identification of CMD is essential, as ongoing microvascular dysfunction can contribute to the development of heart failure, arrhythmias, and other adverse long-term cardiovascular outcomes.

Diagnostic evaluation frequently necessitates advanced imaging modalities, such as cardiac magnetic resonance imaging (MRI) or assessment of coronary flow reserve, to directly evaluate microvascular function. Management strategies are multifaceted, centering on the optimization of modifiable risk factors through lifestyle interventions, pharmacologic management of blood pressure, lipid profiles, and glycemic control, as well as therapies targeted at improving microvascular health. Ongoing surveillance and comprehensive risk factor management remain vital for enhancing quality of life and reducing the likelihood of major adverse cardiac events in patients diagnosed with CMD.