Title

Evaluation of Suspected Ischemic Heart Disease in Symptomatic Women

Publication Date

2014

Journal Title

Can J Cardiol

Abstract

There is a wealth of evidence about the role of a variety of diagnostic testing modalities to define coronary artery disease (CAD) risk in women presenting for evaluation of suspected myocardial ischemia. The exercise electrocardiogram (ECG) is the core index procedure, which can define risk in women capable of performing maximal exercise. Stress imaging, using echocardiography or myocardial perfusion single-photon emission computed tomography/positron emission tomography, is useful for symptomatic women with an abnormal resting ECG or for those who are functionally disabled. For women with low-risk stress imaging findings, there is a very low risk of CAD events, usually < 1%. There is a gradient relationship between the extent and severity of inducible abnormalities and CAD event risk. Women at high risk are those defined as having moderate to severely abnormal wall motion or abnormal perfusion imaging findings. In addition to stress imaging, the evidence of the relationship between CAD extent and severity and prognosis has been clearly defined with coronary computed tomographic angiography. In women, prognosis for those with mild but nonobstructive CAD is higher when compared with those without any CAD. The current evidence base clearly supports that women presenting with chest pain can benefit from one of the commonly applied diagnostic testing modalities.

Volume Number

30

Issue Number

7

Pages

729-737

Document Type

Article

EPub Date

2014/03/04

Status

Faculty

Facility

School of Medicine

Primary Department

Cardiology

Additional Departments

Occupational Medicine, Epidemiology and Prevention

PMID

24582723

DOI

10.1016/j.cjca.2013.09.019