Approach to Imaging Ischemia in Women.

Area of Science:

• Cardiology
• Medical Imaging
• Women's Health

Background:

• Coronary artery disease (CAD) presents unique challenges in women, often with worse prognosis than in men.
• Women less frequently exhibit classic anginal symptoms, complicating diagnosis.
• Exercise treadmill testing underperforms in women, necessitating alternative diagnostic strategies.

Approach:

• This review focuses on the sex-specific pathophysiology of ischemic heart disease in women.
• It compares obstructive and nonobstructive CAD subtypes.
• The review highlights advanced imaging modalities for improved diagnosis.

Key Points:

• Nonobstructive CAD is more common in women with ischemic symptoms, requiring specialized imaging.
• Advanced imaging techniques like coronary CT angiography and cardiac MRI offer superior sensitivity and specificity.
• Coronary CT angiography, CT myocardial perfusion imaging, and CT functional flow reserve assessment are key tools.

Conclusions:

• Accurate diagnosis of CAD in women relies on understanding sex-specific disease patterns.
• Selecting appropriate advanced imaging tests is crucial for effective diagnosis.
• Improved diagnostic approaches can lead to better management and outcomes for women with ischemic heart disease.