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Stanford Health Care

Diagnosis

How We Can Help You 

Endothelial dysfunction is a type of non-obstructive coronary artery disease (CAD) in which there are no heart artery blockages, but the large blood vessels on the heart’s surface constrict (narrow) instead of dilating (opening).

This condition tends to affect more women than men and causes chronic chest pain. Because most clinics do not diagnose or treat endothelial dysfunction, people with this condition may feel frustrated and hopeless.

At Stanford’s Women’s Heart Health Clinic, our specialists actively look for endothelial dysfunction and other hard-to-detect non-obstructive coronary artery diseases. We use leading diagnostic tests to confirm an accurate diagnosis and provide experienced-based treatment approaches to ease symptoms and reduce future cardiac issues.

What We Offer You For Endothelial Dysfunction

  • Nationally recognized expertise in nonobstructive coronary artery diseases, such as endothelial dysfunction, with one of the most robust programs in the U.S.
  • Advanced diagnostic tests that can determine the function of the coronary arteries and give a specific diagnosis for this hard-to-detect disease.
  • Comprehensive treatment options, including medication and one of the country’s most advanced behavior modification programs for people with heart disease.
  • Team-based approach that brings together cardiologists, psychologists, dietitians, and other specialists to create a care plan tailored to your needs.
  • Robust support services including mindfulness classes and nutrition counseling to help people with heart disease make healthy lifestyle changes.
  • Active research program with an extensive, ongoing patient registry that contributes to our understanding of this and other little-known heart conditions.

Treatment for Endothelial Dysfunction

At our Women’s Heart Health Clinic, we frequently see women with chest pain but no physical blockages of the arteries. We conduct thorough diagnostic tests to determine if they have nonobstructive coronary artery disease, including endothelial dysfunction.

We listen to your concerns and evaluate your entire coronary circulation. Once we confirm a diagnosis of endothelial dysfunction, we discuss the treatment options that most suit your needs.

Our approach to treatment includes:

Stanford has one of the country’s most comprehensive programs for treating nonobstructive coronary artery disease.

Lifestyle Modification

To manage endothelial dysfunction and prevent it from getting worse, your doctor talks with you about making lifestyle changes. You may need to: 

  • Eat more healthfully
  • Lose weight
  • Stop smoking
  • Reduce stress
  • Start exercising

Our behavioral psychologists and other specialists in our Cardiac Behavioral Medicine Program support you in making these changes. They, along with your provider, meet with you regularly to help you manage endothelial dysfunction. 

Exercise Counseling

The chest pain from endothelial dysfunction may flare up when exercising, yet exercise is an important part of managing symptoms and preventing the condition from getting worse. We show you ways to modify your exercise routine. We encourage you to exercise up to the point of discomfort, then ease up, and once your symptoms improve, continue.

Stress Management

Stress can make the chest pain from endothelial dysfunction worse. Our behavioral therapists teach you mindfulness-based stress reduction techniques to help you manage stress and chest pain.

Medication

In combination with healthy lifestyle changes, our providers may prescribe one or more medications. They will find the right dosage for you and help manage any possible side effects. Drugs they prescribe may include:

  • Nitrates: These drugs help to open constricted blood vessels, which increases blood flow to the heart and minimizes chest pain.
  • Calcium channel blockers: These medications help relax and widen blood vessels.
  • Statins: These drugs may help repair the endothelium. They also reduce cholesterol levels in the blood, which helps to prevent plaque build-up.
  • Aspirin: Aspirin may prevent blood clots, which can cause a heart attack. Aspirin may also help the damaged endothelium cells to heal.

The specialists at Stanford check in with you regularly to see how you are responding to the treatment plan and adjust it as necessary to help you feel your best. 

Clinical Trials

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Open Clinical Trials

View All

Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials.

We have ongoing enrollment in a registry of patients who have nonobstructive coronary artery disease, which helps us understand endothelial dysfunction and other hidden causes of chest pain.

Open trials refer to studies currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.

To learn more about the clinical trials we offer, contact CT CONTACT NAME and Phone NUMBER

Closed trials are not currently enrolling, but may open in the future.

What Is Endothelial Dysfunction?

Endothelial Dysfunction Diagnosis

At Stanford, we use the most advanced technology to diagnose hidden coronary abnormalities, such as endothelial dysfunction, which cannot be seen on an angiogram or other typical diagnostic tests.

Often, when people go to their doctor with chest pain, doctors look for blockages in the blood vessels leading to the heart. However, endothelial dysfunction is a type of nonobstructive coronary artery disease, which means that the arteries are free from blockages. Because it is customary to look for blockages when a person has chest pain, it can be difficult to get to a correct diagnosis of endothelial dysfunction at many other medical centers. 

At Stanford, we look at all possible causes of chest pain, including difficult-to-detect conditions such as endothelial dysfunction.

To check for endothelial dysfunction, we inject a safe medication, acetylcholine, into the large arteries of the heart. Acetylcholine should cause the arteries to dilate. Then, we measure the opening and narrowing of the arteries. If the arteries are not dilating properly, the person may have endothelial dysfunction. 

If the artery does not narrow, but the person experiences chest pain and electrocardiogram (EKG) changes, it may indicate endothelial dysfunction of the microvascular (small) vessels that you cannot see, known as microvascular dysfunction. 

Our Clinics

Women's Heart Health

We provide exceptional heart care that starts with understanding that women’s bodies have different health needs. We treat the whole woman, using evidence-based approaches to prevent and treat heart disease, including conditions like endothelial dysfunction, that mainly affect women.

300 Pasteur Drive
2nd Floor, Room A260
 Stanford, CA 94305
Phone: 650-725-5909 Getting Here
Make An Appointment

To schedule an appointment, please call: 650-723-6459