Exercise-induced myocardial ischaemia in women: factors affecting prevalence

Sports Medicine
J Goodman, Lori D Kirwan

Abstract

Coronary artery disease (CAD) is a major health care challenge, and is the leading cause of death amongst women. Both the delay in the clinical manifestations of CAD and 'atypical' symptomatology in women complicates both diagnosis and treatment strategies in this population. It appears that the age-adjusted prevalence of all-cause angina (effort, unstable, etc.) appears to be greater in women than men, although stenotic lesions are demonstrated less frequently. There are a number of factors that complicates the diagnosis and identification of CAD in women, including more diffuse anginal symptoms, a lower initial detection rate of myocardial ischemia by traditional methods, lower rates of interventional procedures, and lastly, potential differences in the pathophysiology of myocardial ischemia. The lower sensitivity and specificity of many diagnostic techniques including ECG and various imaging technologies contributes significantly to these findings. The increased presence of syndrome X in post-menopausal women may reflect an increased likelihood of microcirculatory disease, where the 'gold standard' angiography fails to detect the presence of disease. Thus nonepicardial coronary stenotic disease may be largely undetected by m...Continue Reading

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Citations

Sep 26, 2003·Scandinavian Journal of Medicine & Science in Sports·T-M AsikainenI Vuori
Mar 26, 2009·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Laurent ChevalierFrançois Carre
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Nov 26, 2009·Circulation·Janneke Berecki-GisolfAnnette Dobson

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