The danger of underdiagnosing coronary microvascular disease in women

ABSTRACT Heart disease is the number one killer of women in the United States. Part of the difficulty with diagnosing heart disease in women is related to a disease process called coronary microvascular disease (CMVD; previously called syndrome X). Also known as nonobstructive coronary artery disease, CMVD is challenging to identify because often there is a lack of convincing evidence of an acute problem during evaluation. In these patients, the epicardial coronary arteries do not have visible blockages, and stress tests often are interpreted as normal or false positive. Therefore, symptomatic patients often are left undiagnosed, frustrated, and at risk of adverse cardiac events. Frequently, the only method of diagnosis is treatment of the symptoms. This information is provided to help advanced practice nurses and other clinicians diagnose and treat CMVD.