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Also known as coronary microvascular dysfunction, coronary dysfunction is a term used to describe a coronary condition where small vessels in the heart are not working properly. This leads to chest pain, a feeling of weakness, fluttering, or an irregular or rapid heartbeat. Coronary Microvascular Disease (MVD) is described by the American Heart Association as “small artery disease or small vessel disease” where the walls and inner lining of tiny coronary artery blood vessels that branch out from the larger coronary arteries are affected. The small muscles feeding the heart muscle are not working properly.
Coronary microvascular disease, which is sometimes referred to as Cardiac syndrome X and Nonobstructive coronary heart disease, is seen more often in women than in men, and often is first noticed with the presence of angina, chest pain, shortness of breath, trouble sleeping, fatigue or a general lack of energy.
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Anytime anyone feels chest pain, clinically referred to as “angina,” they should seek emergency treatment immediately. It is better to have it checked out than to die because of delayed treatment. Angina is described as chest discomfort, squeezing, heaviness, tightness, pressure, aching, burning or numbness. The discomfort is usually felt in in the chest, especially for male patients, but is also felt in the left shoulder, arms, neck, or jaw.
Women present different symptoms of coronary disease, including flu-like exhaustion, nausea, vomiting, light-headedness, extreme weakness or extremely rapid or irregular heartbeats. All of these symptoms require immediate medical attention.
Microvascular dysfunction can be extremely frustrating for claimants. They know they are not feeling right, they are afraid that any kind of exertion or stress will bring on a deadly cardiac event, and yet the tests run by most physicians don’t show that there’s anything wrong with the large arteries bringing blood to the heart. That’s because the problem is in the smaller arteries, which are harder to test.
When a patient comes in with cardiac symptoms, most doctors begin by looking at the larger arteries feeding blood into the heart. When there are no blockages and no narrowing of arteries in the large arteries of the heart, only then will a physician begin to consider coronary microvascular dysfunction.
Diagnosis of microvascular dysfunction and other forms of non-obstructive coronary artery disease requires a very thorough evaluation. The concern is that this may be one of the earliest signs of heart disease, and it could lead to heart failure, heart attack or stroke.
Coronary MVD can be a challenging condition for a disability insurance claim. The symptoms and severity can vary, and the standard tests for coronary heart disease (CHD) will not detect MVD. If the doctor diagnoses you with coronary MVD, your disability insurance company may challenge your claim, saying the condition is not so serious as to prevent you from working.
The problem, as noted above, is that MVD can, if not treated properly, lead to a more serious event, like a heart attack, heart failure or a stroke. Stress is a major trigger factor for cardiovascular diseases like MVD, and a person who has an extremely stressful occupation may find that they are not able to perform at the same level as before their illness struck. Or, they are not willing to sacrifice their life to find out if stress is a contributing factor.
This will be perceived as malingering by the long term disability insurance company and their representatives. It is also unlikely that most of the medical staff at the disability insurance company will be knowledgeable about MVD and how it is diagnosed and treated. Only a highly trained cardiologist who focuses on this particular illness is likely to know of the specialized diagnostic tests, including the index of the microcirculatory resistance (IMR), which is used to measure blood flow in small arteries.
The disability insurance company may look at the claimant’s medical records and conclude that they are not even suffering from heart disease. That is because MVD does not appear in tests that measure blood flow from the large arteries, and measuring blood flow in the small arteries requires specialized tests that may not be available in every health care facility. They may fail to account for a variety of important issue, and rely solely upon a test score.Ready To Talk?
Frankel & Newfield has represented many clients with coronary MVD at various stages of the claim. It is always better for us to be involved with the claim from the very beginning, but often claimants think they can manage their disability insurance claims on their own. We are often contacted after the first series of requests for additional medical records or after there has been a request for an Independent Medical Examination.
The stress that can be created by fighting with a disability insurance company is not worth the risk for the coronary microvascular dysfunction claimant. Our attorneys are experienced with this illness and the challenges that come from the disability insurance company.
Frankel & Newfield is also contacted after the disability insurance company has denied the claim, or terminated benefits after paying for a period of time. When this happens, the claimant realizes that this is not a battle that they are going to be able to win on their own.
We encourage claimants to contact our office at 877-583-2524 at any stage of their claim if they are suffering from coronary microvascular dysfunction. If you have already filed a claim and have been denied, we can fight back on your behalf with an aggressive appeal. Be aware that there may be time constraints if your claim has been denied, so we urge you not to wait and call our office as soon as possible.
Frankel & Newfield has represented individuals with a many different kinds of cardiac diseases. Our first priority is providing our clients with the peace of mind that comes from knowing that we have taken up the burden of fighting with the disability insurance company.Ready To Talk?
Jason A. Newfield - Disability Insurance Attorney
Jason Newfield is a founding partner of the disability insurance law firm Frankel & Newfield. He has spent the majority of his legal career advocating for the rights of disabled workers. He has lectured other professionals, worked on a Federal Advisory committee, and published many articles in the field of disability insurance claims and litigation.
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