(1) Macrovascular disease: Disease of the large blood vessels, including the coronary arteries, the aorta, and the sizable arteries in the brain and in the limbs. Macrovascular disease is by contrast to microvascular disease. In persons with diabetes, chronic hyperglycemia (assessed by glycosylated hemoglobin level) is related to the development of microvascular disease; however, the relation of glycosylated hemoglobin to macrovascular disease is less clear.
Common Misspellings: macrovascular diease, macrovascular desease
(2) Coronary microvascular disease (MVD) affects the heart's smallest coronary arteries. Coronary MVD occurs in the heart's tiny arteries when:
Plaque (plak) forms in the arteries. Plaque is made up of fat, cholesterol (ko-LES-ter-ol), calcium, and other substances found in the blood. It narrows the coronary arteries and reduces blood flow to the heart muscle. As a result, the heart doesn't get the oxygen it needs. This is known as ischemic (is-KE-mik) heart disease, or heart disease. In coronary MVD, plaque can scatter, spread out evenly, or build up into blockages in the tiny coronary arteries.
The arteries spasm (tighten). Spasms of the small coronary arteries also can prevent enough oxygen-rich blood from moving through the arteries. This too can cause ischemic heart disease.
The walls of the arteries are damaged or diseased. Changes in the arteries' cells and the surrounding muscle tissues may, over time, damage the arteries' walls.
Coronary MVD is a new concept. It's different from traditional coronary artery disease (CAD). In CAD, plaque builds up in the heart's large arteries. This buildup can lead to blockages that limit or prevent oxygen-rich blood from reaching the heart muscle.
In coronary MVD, however, the heart's smallest arteries are affected. Plaque doesn't always create blockages as it does in CAD. For this reason, coronary MVD also is called nonobstructive CAD.
No one knows whether coronary MVD is the same as MVD linked to other diseases, such as diabetes.