Gender and microvascular angina

Integrated Physiologic Assessment of Ischemic Heart Disease in Real-World Practice Using Index of Microcirculatory Resistance and Fractional Flow Reserve

“…Nonetheless, recent studies report sex differences in the presentation, diagnosis, management, and pathophysiological mechanisms of CAD. 17 So-called cardiac Syndrome X, which is the presence of myocardial ischemia without significant epicardial coronary stenosis, is more common in females, 18 and recent reports suggest that microvascular dysfunction might be the main pathophysiological mechanism in this condition. [18][19][20] Luo et al presented that the patients with cardiac syndrome X (female 72% of the patients) had significantly higher IMR compared with ageand sex-matched control patients (33.1±7.9 versus 18.8±5.6, P<0.01).…”

Disparities in Heart Failure and other Cardiovascular Diseases among Women

“…Symptomatology may be different, causing women to delay seeking medical care longer than men because they may experience vague symptoms, such as unusual fatigue and shortness of breath, that they may not associate with CHD. Even when women seek care, they may present with atypical chest pain or may not report experiencing any chest pain, so symptoms may not be recognized as cardiac in origin [19,21]. The severity of the illness is frequently underestimated [2,22].…”

The enigma of heart disease in women: New insights may precipitate diagnosis and improve patient outcomes

“…Significant evidence now exists to conclude that despite the absence of obstructive epicardial coronary occlusions (clear coronary arteries) in some women, coronary ischemia can exist. CMD and/or endothelial dysfunction account for nearly half of the heart disease cases in women (Nugent, Mehta, & Bairey Merz, 2010; Reis et al, 2001). A better understanding of the pathophysiology of heart disease in women, and recognition of atypical clinical manifestations and unique risk factors will enable earlier detection and prevention of adverse outcomes.…”