Heart Disease Underdiagnosed in Women
New research finds that heart disease in women may be underdiagnosed on standard scans, as women can face significant cardiovascular events at lower levels of coronary plaque compared to men. The study reveals sex differences in coronary plaque burden and cardiovascular event risk, highlighting the need for improved diagnostic protocols. Women may experience heart attacks at lower levels of visible arterial plaque than men, calling for more nuanced risk assessment.
- Heart disease is the leading cause of death for women in the United States, accounting for one in every five female deaths. Historically, it was considered a man's disease, leading to women being underrepresented in major cardiovascular research. - Women are more likely than men to experience a heart attack without the classic symptom of chest pain. Instead, they may have symptoms like shortness of breath, nausea, vomiting, unexplained fatigue, and pain in the jaw, neck, or back. - Studies have shown that women, particularly those under 55, who go to the emergency room with heart attack symptoms are more likely than men to be misdiagnosed and sent home. - Coronary microvascular dysfunction (CMD), a condition affecting the heart's smallest arteries, is more common in women and can cause chest pain without significant blockages in the main arteries. Standard diagnostic tests for heart disease may not detect CMD. - Pregnancy-related conditions such as pre-eclampsia, gestational diabetes, and hypertensive disorders of pregnancy can increase a woman's long-term risk of developing cardiovascular disease. - The American Heart Association has issued specific guidelines for preventing heart disease in women, which categorize them by their 10-year risk of a cardiac event and recommend tailored prevention strategies. - Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a type of heart attack that occurs with less than 50% blockage in the main coronary arteries and disproportionately affects younger women. New clinical guidelines are being developed to improve its diagnosis and treatment. - Research has shown that women often have a higher burden of symptoms and are more likely to have non-obstructive coronary artery disease, where plaque is more diffusely spread out rather than concentrated in a single blockage.
