Gyn
Heart Disease in Women
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Heart Disease in Women
, Coronary Artery Disease in Women
Pathophysiology
Contributing factors specific to women
Premature
Coronary Artery Disease
affects women to greater extent than men
Obstetric cardiovascular complications
Preeclampsia
Gestational Diabetes
Hormonally-related issues
Hyperandrogenic states such as
Polycystic Ovary Syndrome
Hormone Replacement Therapy
Surgical
Menopause
or other hypoestrogenemia cause
Vascular conditions more common in women
Vasculitis
(esp. collagen vascular disease)
Stress Cardiomyopathy
(transient myocardial syndrome with extreme stress)
Coronary or aortic root dissection
Symptoms
Atypical or vague compared with men (present to ERs 2 hours after men)
Chest Pain
Back, neck,
Shoulder
, or
Abdominal Pain
Shortness of Breath
Nausea
or
Vomiting
Cold sweats
Fatigue
Weakness
Anxiety
Anorexia
Evaluation
Framingham Score
and NCEP III guidelines underestimate risk in women
Does not account for
Obesity
, inactivity,
Hypertriglyceridemia
,
Family History
Reduced non-invasive stress
Test Sensitivity
in women
Women often have single vessel disease
Women more often fail to reach a maximal stress test (>5 Mets are required)
ST depression and
Chest Pain
with
Exercise
are not good predictors in women
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