Small vessel malady bane to women.

• Position: Heart Disease - Brief article

Why do more females than males die of heart disease, and why do some women with heart disease fare less well than men after treatment to open large coronary arteries? According to researchers at the Mayo Clinic, Rochester, Minn., the answer may be small vessel heart disease, an often unrecognized problem that poses a high risk of heart attack or heart failure.

Coronary arteries on the outer surface of the heart branch into many smaller vessels, which supply blood directly to the heart's muscle tissue. Normally, these vessels expand when the heart needs more blood--during exercise or stress. With small vessel heart disease, the vessels fail to expand properly and even may get smaller during physical or emotional stress. This lack of dilation can cause symptoms similar to a heart attack. While reduced blood flow to the heart can cause chest pain, pressure, or discomfort, sometimes the symptoms of small vessel disease in women are more subtle, such as fatigue during everyday activities or mental stress.

Diagnosing the condition can be tricky because...