MICROVASCULAR DISEASE Sample Clauses

MICROVASCULAR DISEASE. A common area that can cause discrepancy between the results of non-invasive and invasive tests is in coronary microvascular disease, in which functional and structural abnormalities of the coronary microvasculature can lead to microvascular ischaemia. Microvascular disease is defined as reduced coronary flow reserve in the absence of an epicardial stenosis and can be primary or secondary. Primary microvascular disease occurs in the absence of any other cardiac cause and the underlying disorder is thought to be due to vascular abnormalities of the endothelial cells, smooth muscle cells and the autonomic nervous system resulting in raised microvascular resistance. Secondary microvascular disease can occur due to conditions such as hypertension, hypercholesterolaemia, left ventricular hypertrophy and diabetes. Similar mechanisms are at play in patients with risk factors for CAD. Left ventricular hypertrophy is also thought to result in raised microvascular resistance due to increasing myocardial fibrosis. Furthermore, having epicardial coronary disease itself is associated with concomitant microvascular disease.
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