Cardiovascular disease in women: heart disease across the life span

Area of Science:

• Cardiology
• Women's Health
• Diagnostic Imaging

Background:

• Women frequently present with atypical cardiovascular symptoms, differing from men.
• This disparity can result in delayed diagnosis and suboptimal management of coronary artery disease (CAD).
• Early and accurate diagnosis is crucial for effective cardiovascular disease management in women.

Purpose of the Study:

• To review the diagnostic approaches for coronary artery disease (CAD) in women.
• To discuss current therapeutic strategies for CAD management in the female population.
• To highlight specific cardiovascular conditions more prevalent in women, such as Takotsubo cardiomyopathy.

Main Methods:

• Review of current literature on CAD diagnosis and treatment in women.
• Analysis of the role of exercise stress testing, with and without imaging modalities (echocardiography, nuclear medicine, CT, MRI).
• Examination of pharmacological and interventional treatment options for CAD in women.

Main Results:

• Exercise stress testing is the primary diagnostic tool for women with suspected CAD.
• Adding imaging to exercise stress tests enhances diagnostic accuracy.
• Pharmacological management includes antiplatelets, beta-blockers, lipid-lowering drugs, ACE inhibitors, calcium channel blockers, and nitrates.
• Invasive procedures like angioplasty and bypass surgery are less common in women compared to men.
• Takotsubo cardiomyopathy is more prevalent in postmenopausal women.

Conclusions:

• Atypical symptoms in women necessitate careful evaluation for CAD.
• Enhanced diagnostic strategies, including imaging with stress tests, are vital for women.
• While initial treatments are similar, treatment approaches may need consideration for sex-specific differences.
• Takotsubo cardiomyopathy represents a unique cardiovascular concern in older women.