What do Cardiologists Expect from Imaging For Ischemic Heart Disease in Women

Abstract

Ischemic heart disease (IHD) is an important cause of morbidity and mortality in women and men. This paper emphasizes the differences of IHD in women, focusing on the diagnostic investigation in its stable phase.

The higher prevalence of atypical symptoms, anatomical differences, and adverse psychosocial aspects, in addition to the association of specific risk factors regarding obstetrical history, requires an accurate clinical assessment and a targeted diagnostic investigation that consider the limitations, as well as the positive and negative predictive values of the methods. Because of breast exposure, tests involving radiation should be reconsidered in selected cases.

It is worth emphasizing that non-cardiological tests often performed in women, such as mammography, provide an opportunity to assess CVR at early ages or even in patients with few traditional risk factors.

Complementary tests for microcirculation assessment should be used in cases of proven ischemia in the absence of obstructive coronary artery disease, which is known to be more frequent in women.