New Insights Into Ischemic Heart Disease in Women: The Central Role of Coronary Microvascular Dysfunction Current Insights, Diagnostic Advances, And Therapeutic Uncertainties

Introduction

This viewpoint discusses emerging evidence and the clinical implications of coronary microvascular dysfunction (CMD) in women, offering a focused perspective on pathophysiologic, diagnostic, and therapeutic features that distinguish ischemic heart disease (IHD) in women from that in men. Beyond summarizing available data, we highlight the growing body of evidence supporting CMD as an important and often underrecognized contributor to ischemic symptoms and cardiovascular risk in women. We emphasize key concepts and ongoing controversies without intending to provide definitive therapeutic recommendations.

Ischemic heart disease (IHD) remains a leading cause of morbidity and mortality worldwide. Recent evidence also highlighted sex-based differences in ischemic pathophysiology and vascular aging in women.

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