The symptoms of chronic microvascular ischemia within coronary arteries include angina, shortness of breath, sleep disturbance, lack of energy and fatigue, according to the National Heart, Lung and Blood Institute. It is possible to confuse the symptoms of coronary microvascular ischemia with symptoms of the flu or a heart attack, according to Brigham and Women's Hospital.
Coronary microvascular ischemia occurs when atherosclerotic plaque is uniformly deposited around the walls of small blood vessels in the heart over time. This causes the blood vessels to become hard and stiff, which means they no longer expand well in response to the demands of the heart, such as physical exertion, according to Brigham and Women's Hospital. This differs from coronary artery disease which is characterized by sporadic accumulations of plaque that extend into the center of the blood vessel, impeding blood flow through the heart and reducing oxygen delivery.
The characteristics of the chest pain that often occurs in coronary microvascular disease may differ from that of coronary artery disease, according to the National Heart, Lung and Blood Institute. With microvascular disease, chest pain usually lasts longer than 10 minutes and can continue for over 30 minutes. Furthermore, coronary microvascular ischemia symptoms occur during or after routine daily activities, whereas the symptoms of coronary artery disease more often occur during or after more intense physical activities.