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And the worst part: she is not alone.

she is not alone.

I regularly hear from women who have been finally diagnosed, sometimes after years of suffering and diagnostic failures. I know that I won the heart patients’ lottery when I met my two well-informed professionals.

If you too have been diagnosed with coronary microvascular disease, Dr. Stacey Rosen suggests that you must see your doctor regularly, be scrupulous about taking your medications and making important lifestyle changes, and be prepared to call for immediate help if you even think you may be having a heart attack. Shortness of breath, crushing fatigue or pain in the jaw, left arm, back or neck may be warning signs of microvascular dysfunction or an imminent heart attack. Read more about heart attack symptoms as well as early warning signs .

Q: Have you or somebody you care about been diagnosed with Coronary Microvascular Disease?

See also:

Patient-Friendly, Jargon-Free Glossary

I wrote more about coronary microvascular disease in my new book, “A Woman’s Guide to Living with Heart Disease” (Johns Hopkins University, November 2017.

“A Woman’s Guide to Living with Heart Disease”
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Misdiagnosed: women's coronary microvascular and spasm pain

Heart disease, like cancer, is not one but several disorders. And at least two of these disorders are far more likely to show up in women than in the "Hollywood Heart Attacks" of our male counterparts. For all heart attack survivors whose debilitating cardiac symptoms may have been blown off…

In "Cardiology 101"

How women can have heart attacks without having any blocked arteries

Heart attacks caused by massive blockages in coronary arteries may be less common in women, who often suffer something called Inoperable Coronary Microvascular Disease instead.

In "Cardiology 101"

No blockages: Living with non-obstructive heart disease

Annette is part of an often misunderstood population living with a very different type of heart disease. Diagnosed at age 41, she was shocked to learn that her cardiac symptoms of severe chest pain, shortness of breath and crushing fatigue were NOT being caused by blocked coronary arteries.

In "Cardiology 101"

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It is now well established that there is a relationship between sealing capacity of a fault and the clay content of lithic fragments and fault rocks it contains (e.g. see Fisher Knipe 2001 ; from china free shipping low price shopping online cheap online adidas Womens Athletics 24/7 W Black/White 95 US buy cheap eastbay VsE917zwyY
and references therein). Consequently, many fault seal algorithms calculate the clay content of seismic-scale faults by integrating fault throw with the clay content of host stratigraphy – e.g. Shale Gouge Ratio (SGR, Yielding et al. 1997 ); Clay Smear Potential (CSP, Bouvier et al. 1989 ); Shale Smear Factor (SSF, Lindsay et al. 1993 ); Probabilistic Shale Smear Factor (PSSF, Childs et al. 2007 ); Effective Shale Gouge Ratio (ESGR, Freeman et al. ). Yielding et al. provide a review of fault rock capillary seal mechanisms and industry standard clay-content prediction algorithms, and they compare and contrast deterministic and empirical approaches to predicting static fault sealing potential. The deterministic approach correlates laboratory-measured capillary threshold pressure and clay content of fault rock samples – with predicted clay content of seismic-scale faults (e.g. by using modelled SGR values as a proxy for clay content). The empirical approach compares SGR values modelled on known sealing faults in a field, with PWC and pressure differences measured in the field. Building on the work presented in Yielding (2002) , the authors show that there is some similarity in the results from these two calibration methods, which might be coincidental, given the heterogeneous nature of fault zones. They conclude that whilst further work is needed to improve understanding of fault zone heterogeneity, the deterministic and empirical approaches are not mutually exclusive – but, rather, on a practical level they provide alternative scenarios within an acceptable range of subsurface uncertainty.

Freeman et al. Yielding et al.

In recent years, there have been major advances in our understanding and modelling of 3D depositional architectures and the heterogeneity of fault damage zones and fracture arrays. It is now common practice for appraisal and development teams to work on a range of complex geological concepts and for them to construct detailed model scenarios – in order to capture subsurface uncertainty. Freeman et al. address the characterization and visualization of fault zone heterogeneity in fault seal analysis and reservoir modelling. It has been possible to incorporate some of these complexities into existing modelling tools (e.g. Manzocchi et al. 2010 ). However, the authors contend that new analytical and intuitive visualization methods are needed to enhance or replace those that were developed over a decade ago when requirements were simpler. The paper presents enhanced visualization techniques – and provides a formal definition of the ESGR algorithm (evolved from SGR) – in the context of a detailed comparative review of commonly used clay-prediction algorithms (SGR, ESGR, CSP, SSF, PSSF). The authors also introduce ‘intuitive’ parameters, such as fault hydraulic resistance, and Effective Cross Fault Permeability and Transmissibility (ECFP, ECFT) – that take into account the flow properties of the host reservoir, and the complex flow properties of the fault zone, and the fault-damaged hanging wall and footwall rock volumes. When tested in a flow simulator, these parameters provide a more robust correlation with cross-fault fluid flux than host- or fault rock permeabilities alone. Irving et al. note that a key problem with modelling fluid flow in petroleum reservoirs is that subsurface data used to populate models is limited to spatially extensive low resolution seismic data or sparse high resolution well data. A workflow is presented to fill this sampling gap by the generation of multiple realizations in which fault geometry and properties can be varied in geological models so the impact of these uncertainties on production forecasts can be assessed. Static properties such as total connected gas volume are calculated for each model. A selection of these models was then incorporated into production simulation models to allow the assessment of structural uncertainty on predictions of the dynamic behaviour of the reservoir. The workflow is applied to a North Sea reservoir, in which it is shown that fault geometry and permeability are the most important properties although the relative significance of these properties varies throughout field life. Although a reasonably good ‘history match’ (i.e. a correspondence between numerically simulated and actual time-lapse production data) is achieved using the workflow, the paper indicates that further improvements may be achieved by incorporating stress and saturation dependent fault properties into the simulation model.

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