Evaluating Ischemic Heart Disease in Women: Focus on Angina With Nonobstructive Coronary Arteries (ANOCA)

Area of Science:

• Cardiology
• Women's Cardiovascular Health
• Diagnostic Medicine

Background:

• Ischemic heart disease (IHD) is prevalent in women, with cardiovascular disease being a major cause of illness and death.
• Millions of women have angina with nonobstructive coronary arteries (ANOCA), a group of disorders affecting the coronary arteries without atherosclerosis.
• Diagnosing ANOCA can be difficult, leading to delayed treatment and impacting women's quality of life and long-term heart health.

Purpose of the Study:

• To review recent advancements in diagnostic testing for evaluating angina in women.
• To present a practical diagnostic algorithm for assessing ANOCA in symptomatic patients.
• To emphasize a personalized diagnostic strategy based on patient history and pretest probability.

Main Methods:

• Review of current literature on diagnostic advancements for ANOCA.
• Development of a pragmatic diagnostic algorithm for ANOCA evaluation.
• Emphasis on integrating clinical interview and pretest probability into diagnostic strategy.

Main Results:

• Significant progress has been made in recognizing and diagnosing ANOCA in the last decade.
• Current diagnostic approaches often overlook ANOCA, focusing primarily on obstructive coronary artery disease.
• A personalized diagnostic strategy, informed by clinical assessment, is crucial for accurate ANOCA diagnosis.

Conclusions:

• Advances in diagnostic testing offer improved evaluation of angina in women.
• A structured diagnostic algorithm can guide the assessment of ANOCA.
• Personalized diagnostic strategies are essential for timely and accurate diagnosis and treatment of ANOCA in women.