Cardiology for gynecologists--a minireview

Area of Science:

• Cardiology
• Women's Health
• Preventive Medicine

Background:

• Cardiovascular disease (CVD) is the leading cause of death globally among women, yet awareness remains low.
• Myocardial infarction (MI) in women often occurs a decade later than in men and may present with atypical symptoms like dyspnea, differing from the typical chest pain.
• A significant proportion of women experience myocardial infarction with normal coronary angiography, potentially due to underlying microvascular disease or coronary spasm, conditions now recognized as having similar prognoses to obstructive disease.

Purpose of the Study:

• To highlight the low awareness of cardiovascular disease (CVD) in women.
• To underscore the unique risk factors and atypical presentations of CVD in women.
• To emphasize the critical role of gynecologists in early CVD detection and prevention strategies.

Main Methods:

• Review of current literature on cardiovascular disease epidemiology, risk factors, and clinical presentation in women.
• Analysis of gender-specific differences in myocardial infarction (MI) presentation and diagnostic findings.
• Examination of unique female risk factors including pre-eclampsia, gestational diabetes, and polycystic ovary syndrome (PCOS).

Main Results:

• Myocardial infarction (MI) occurs approximately 10 years later in women than men, with atypical symptoms such as dyspnea being more common than chest pain.
• Women are more likely to have MI with normal coronary angiography, linked to microvascular disease or coronary spasm.
• Specific risk factors for women include a history of pre-eclampsia, gestational hypertension or diabetes, and polycystic ovary syndrome (PCOS). Atrial fibrillation poses a greater stroke risk for women.

Conclusions:

• Cardiovascular disease (CVD) presents unique challenges in women, necessitating increased awareness and tailored screening.
• Gynecologists are uniquely positioned to identify cardiovascular risks in women from an earlier age.
• Preventive measures, including lifestyle modifications and management of risk factors, can significantly reduce CVD mortality in women, with 6 out of 10 deaths being preventable.