A narrowing of one or more arteries in the heart is called a Coronary Artery Disease. The risk of a heart attack is related to the shape of the arteries.

“Non-obstructive coronary arteries disease is a dangerous disease. This is when the heart’s arteries are compressed by surrounding heart muscle tissue or are compromised by something other than the blood vessels.”

Many of the same risk factors that contribute to obstructive CAD are also the cause of non-obstructive coronary arteries disease.

“There isn’t plaque in the images that can be used to identify non-obstructive CAD. Treatment usually involves lifestyle changes. When medications aren’t effective, surgery may be necessary.”

Non-obstructive CAD differs from obstructive CAD — what most people think of when discussing coronary artery disease — in some important ways. To better understand the distinctions, it’s important to understand traditional CAD and its complications.

Obstructive CAD

The clinical term for blocked or narrowed arteries is atherosclerosis, which causes obstructive CAD. The arterial plaque deposits that cause atherosclerosis comprise cholesterol, fats, white blood cells, and other substances.

About half of all older Americans are unaware they have atherosclerosis.

In atherosclerosis, the coronary arteries can become so narrow that the heart muscle can starve of oxygen-rich blood, resulting in a heart attack.

A plaque that has been at the site for a while is a common cause of the problem. This can cause a blood clot to form, blocking blood flow and triggering a heart attack.

A significant decrease in blood flow through the coronary arteries can also cause angina, chest pain brought on by poor blood supply to the heart.

Non-obstructive CAD

Non-obstructive CAD is a major risk factor for heart attack.

A 2014 study in JAMA suggests that non-obstructive CAD patients are two to four times more likely to experience a heart attack than patients with no apparent CAD.

People with obstructive CAD often exhibit angina along with the following symptoms.

Non-obstructive CAD is not the result of attitude but is related to other types of coronary arteries.

  • The inner lining of one or more coronary arteries is damaged.
  • abnormal constriction of the coronary arteries (coronary vasospasm)
  • The smaller blood vessels that branch off the main coronary arteries have problems.
  • Pressure from the heart muscle.

Non-obstructive CAD can present in many forms.

A 2021 study, for example, suggests that about two-thirds of people with non-obstructive CAD have coronary microvascular dysfunction — a condition likely triggered by common heart disease risk factors such as:

“These risk factors can cause problems. The cause of coronary arteriosclerosis, the constriction of the heart’s arteries, isn’t well understood. The other form of non-obstructive CAD is called myocardial blepharitis.”

Non-obstructive CAD usually begins with:

  • “A review of the person’s medical history.”
  • A review of family history.
  • A physical exam.

A 2018 review of numerous studies also suggests that receiving an accurate diagnosis requires your healthcare professional to exclude other potential causes of your symptoms. Other non-cardiac conditions that could cause similar symptoms include:

“A combination of tests should be used to reach a diagnosis. A stress test to gauge blood flow and heart function can be helpful, but wouldn’t reveal the presence of non-obstructive CAD.”

Other screenings include:

  • The cardiac Magnetic Resonance instrument.
  • The echocardiogram shows the results.
  • The electrocardiogram is alectrocardiogram.

But the most definitive test for non-obstructive CAD, according to a 2019 study, is angiography.

A dye that travels through the bloodstream in the heart can be easily identified by special X-ray equipment. This method can show if a blocked coronary arteries is affecting the circulation of the heart.

The nature of your non-obstructive coronary arteries disease determines treatment. Managing the condition is done through lifestyle and clinical approaches.

Lifestyle changes

Mild cases of non-obstructive CAD that do not have symptoms may not need treatment.

If you have an angina symptom and your doctor discovers that you have a problem with the arteries, you may need to adopt more specific heart-healthy behaviors.

  • Most days of the week, you can exercise for 30 to 40 minutes.
  • The Mediterranean or DASH diet is a good example of a balanced diet.
  • Getting enough sleep.
  • limiting the amount of alcohol consumed.
  • Managing stress.
  • No smoking.

Clinical treatments

Some underlying atherosclerosis may be present even though non-obstructive CAD is not the result of cholesterol-laden plaque formation in the arteries.

To lower cholesterol levels and reduce the risk of atherosclerosis, a statin prescription is often used to manage non-obstructive CAD and lower future cardiac risks, according to researchers published in the Journal of the American College of Cardiology.

Additional preventive therapies and medications may be used.

Other medications that may be appropriate for non-obstructive CAD include antihypertensive medications to lower blood pressure, including ACE inhibitors, beta-blockers, and calcium channel blockers.

If myocardial blepharitis is diagnosed, surgery may be needed to fix the heart. The removal of heart muscle tissue is called unroofing.

Non-obstructive coronary arteries are a serious risk factor for a heart attack.

The condition is caused by problems in the arteries, not plaques. It may require several tests to get an accurate diagnosis.

If you have symptoms such as angina or other signs of a heart problem, it is important to get a diagnosis from your cardiologist and put together a treatment plan.

If you have non-obstructive CAD, you may need to change your lifestyle and take medication to prevent the development of obstructive CAD.