[Women and cardiovascular disease]

Area of Science:

• Cardiology and Women's Health
• Investigating female-specific cardiovascular disease pathophysiology and clinical presentations.

Context:

• Cardiovascular disease (CVD) mortality in women exceeds cancer mortality, highlighting a significant health disparity.
• Women exhibit unique CVD pathophysiology, including fragile coronary arteries and microvascular ischemia.
• Atypical symptoms (dyspnea, nausea, fatigue) are common in women with acute coronary syndromes.

Purpose:

• To review the female-specific aspects of cardiovascular disease, including pathophysiology, diagnosis, and treatment.
• To emphasize the challenges in diagnosing heart disease in women and the need for tailored approaches.
• To highlight disparities in guideline adherence and prognosis for women compared to men.

Summary:

• Diagnostic tests like exercise ECG can be challenging to interpret in women; normal coronary angiograms do not rule out coronary heart disease.
• Myocardial perfusion scintigraphy is a valuable tool for high-risk women with suspected coronary heart disease and inconclusive standard tests.
• Women are less likely to receive guideline-recommended treatments and have worse prognoses post-myocardial infarction or intervention.

Impact:

• Recognizing female-specific risk factors like gestational hypertension and diabetes enables early detection and intervention.
• Addressing diagnostic and treatment disparities is essential to improve cardiovascular outcomes for women.
• Further research and clinical practice adjustments are needed to optimize cardiovascular care for women.