Microvascular Disease

Microvascular Disease

Microvascular disease (also known as coronary microvascular disease, or CMD) is a complex and often underdiagnosed cardiovascular condition. At Tampa General Hospital, we address the unique challenges posed by CMD through our specialized Coronary Microvascular Dysfunction Program.

Microvascular disease is characterized by dysfunction in the small arteries of the heart and is distinct from the more commonly known coronary artery disease (CAD), which affects the larger arteries in the heart.

With an unwavering commitment to advancing the field of cardiac care, our multidisciplinary team at Tampa General Hospital's Heart and Vascular Institute harnesses the latest technologies and research to provide comprehensive microvascular disease diagnosis and treatment. We are proud to have been recognized as a “High Performing” hospital in Heart and Vascular care for 2023-2024 by U.S. News and World Report.

Causes and Risk Factors of Microvascular Disease

Microvascular disease is influenced by a variety of factors, both intrinsic (things you can’t change) and lifestyle related. It's crucial to understand the elements that contribute to this complex condition. The condition is often associated with:

  • Hypertension
  • Dyslipidemia
  • Diabetes
  • Obesity
  • Tobacco use
  • Being female (although males can also be affected)

Microvascular Disease Symptoms

Recognizing the symptoms of coronary microvascular disease is essential for early diagnosis and intervention. These symptoms may include:

  • Chest pain or tightness (angina)
  • Neck, shoulder, arm or back pain
  • Shortness of breath
  • Fatigue

Diagnosis of Microvascular Disease

At TGH, our team employs a comprehensive patient evaluation process that goes beyond conventional practices. Diagnosing CMD can be challenging, but our approach begins with a thorough history and physical exam to rule out symptoms of myocardial ischemia or other underlying conditions. Once more common medical conditions are excluded, our microvascular disease assessment begins.

We utilize the Coroventis‡ CoroFlow‡ Cardiovascular System, an advanced tool that measures physiological indices, including fractional flow reserve (FFR), resting full-cycle ratio (RFR), coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR) to assess both epicardial and microcirculatory flow—in other words, we measure how well your heart is functioning. Our goal is to provide patients with a clear CMD diagnosis, which can help pave the way for improving their quality of life.

Treatment Options for Microvascular Disease

Following diagnosis, we provide personalized treatment plans to meet the needs and goals of each patient. Those with abnormal findings on their microvascular disease studies can receive follow-up care in our CMD Medical Clinic. Treatment options may include:

Lifestyle Changes

CMD can often be managed effectively by making healthy lifestyle changes, such as:

  • Smoking cessation
  • Exercise/cardiac rehabilitation
  • Nutrition improvement
  • Weight management
  • Stress reduction

Risk Factor Management

Effective management of risk factors is pivotal in the care and treatment of microvascular disease. Controlling these factors can significantly influence the progression and severity of CMD:

  • Diabetes
  • High cholesterol
  • High blood pressure


For some patients, medication may be necessary alongside lifestyle changes and risk factor management. Common medications used to treat CMD include statins, angiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARBs), beta blockers, calcium channel blockers and nitrate therapy. Individualized treatment regimens are key to our approach.

Clinical Trials

The CMD Program at TGH is at the forefront of cardiac disease research and has access to industry- and physician-sponsored clinical trials, such as the Discover INOCA study. These efforts contribute to defining diagnostic and treatment approaches to CMD management for future patients.

Become a TGH Patient

If you suspect that you have microvascular disease or want to seek specialized care for your heart health, we invite you to become a patient at Tampa General Hospital. Contact our expert team at (813) 844-3900 to schedule an appointment.