sarah371 - Yes, coronary microvascular disease is related to "small vessel disease" in the brain.
Microvascular disease is systemic so it is not a surprise. I also am in the same boat.
For the brain there is really nothing to do...but do treat your coronary microvascular disease with medications and life style changes - which, in turn, will also help your brain. As you know "microvascular disease" in the heart can not be stented...only the large, major coronary arteries can be stented. Yes, it is the same as the heart...the culprit is plaque build up through the years. And, in my case, it's also genetic. For the heart the result is chronic, periodic angina attacks - main medication is Ranexa to combat this chronic angina. Talk to your cardiologist. At the very least you should be on low dose aspirin, a beta blocker, a calcium channel blocker, cholesterol lowering medication(s) and ranitidine (generic for Ranexa). Plus and this is a big plus - healthy life style changes no matter your age. Healthy eating, lots of fruits and veggies, weight control, exercise and stress management. And you should also be under the care of a neurologist for your brain condition. I also have migraines...a double whammy which are hard to get under control. The head pain almost constant despite medications and because of the coronary MVD I can not take the triptans or NSAIDs (Advil, Motrin, Aleve, etc.) b/c they can cause a heart attack.
I try not to think or stress about the small vessel disease in my brain...because the only thing I can do is manage my heart well with medications and life style changes which will only help the brain also. That's it.
The cards we have been dealt. The only thing to do is deal. Wishing you the very best. You are not alone!