Abstract:
:Although differences diminish with age, outcomes are overall worse for women compared to men who present with suspected acute coronary syndrome. The reasons for this discrepancy are multifactorial, including sex-related differences in atherosclerosis biology and fluid dynamics, as well as a premature conclusion by providers that chest pain must be noncardiac in the absence of obstructive coronary artery disease. In this review of existing literature, we explore the diverse differential diagnosis in this unique set of patients. Especially in women with persistent symptoms, absence of occlusive disease should prompt consideration for subangiographic plaque disruption, epicardial or microvascular endothelial dysfunction, transient neurohormonal imbalance predisposing to Takotsubo cardiomyopathy or spontaneous coronary artery dissection, underlying systemic inflammatory conditions, thromboembolic disease, myocarditis, and sequelae of congenital heart disease. As always, a thorough history and attentive physical exam will help guide further work-up, which in many cases may warrant noninvasive imaging, such as contrast-enhanced echocardiography, cardiac magnetic resonance imaging, or positron emission tomography, with their respective means of measuring myocardial perfusion and myocardial tissue pathology. Lastly, intracoronary imaging such as intravascular ultrasound and optical coherence tomography and invasive diagnostic methods such as coronary reactivity testing continue to add to our understanding that what appear to be atypical presentations of ischemic heart disease in women may in fact be typical presentations of pathologic cousin entities that remain incompletely defined.
journal_name
Curr Cardiol Repjournal_title
Current cardiology reportsauthors
Joly JM,Bittner Vdoi
10.1007/s11886-016-0767-0subject
Has Abstractpub_date
2016-09-01 00:00:00pages
84issue
9eissn
1523-3782issn
1534-3170pii
10.1007/s11886-016-0767-0journal_volume
18pub_type
杂志文章,评审abstract::Noninvasive cardiac imaging techniques have made a striking impact on the evaluation and management of pericardial disorders. Two-dimensional and Doppler echocardiography are the methods of choice in the evaluation of pericardial effusion and cardiac tamponade. Magnetic resonance imaging, computed tomography, and tran...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-002-0124-3
更新日期:2002-01-01 00:00:00
abstract::Aortic stenosis (AS) is the most common primary valve disorder in the elderly with an increasing prevalence. It is increasingly clear that it is also a disease of the left ventricle (LV) rather than purely the aortic valve. The transition from left ventricular hypertrophy to fibrosis results in the eventual adverse ef...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-016-0753-6
更新日期:2016-08-01 00:00:00
abstract::Cardiac resynchronization therapy (CRT) is a proven treatment for heart failure and requires the implantation of a left ventricular (LV) lead, usually placed in a tributary of the coronary sinus. Encouraged by the fact that approximately 30 % of the patients receiving CRT do not benefit from this therapy, LV endocardi...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-012-0298-2
更新日期:2012-10-01 00:00:00
abstract::The heart and kidney interact in terms of hemodynamics and neurohumoral regulatory mechanisms, and this helps to maintain circulatory homeostasis under normal conditions. However, the normal regulatory mechanisms become inappropriate in the setting of congestive heart failure (CHF), and significant renal dysfunction o...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-012-0258-x
更新日期:2012-06-01 00:00:00
abstract::The appropriateness of coronary revascularization for various clinical scenarios has been reviewed formally by several specialty and subspecialty societies resulting in the formulation of scored appropriateness criteria. The goal of the appropriateness criteria is to guide physician decision-making and future research...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-013-0379-x
更新日期:2013-07-01 00:00:00
abstract::One of the most highly unexpected reports in recent medical literature was the lack of benefit of estrogen-progestin replacement therapy in cardiovascular disease prevention in postmenopausal women. The ensuing negative view of hormone replacement therapy has now extended to all forms of postmenopausal hormone treatme...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-003-0110-4
更新日期:2003-11-01 00:00:00
abstract:PURPOSE OF REVIEW:An examination of the current ACC/AHA and ESC/EAS Guidelines on the management of dyslipidemias for common ground and differences. RECENT FINDINGS:There is much common ground. Both note that ASCVD is, in most people, the product of a number of risk factors, notably tobacco exposure, hyperlipidemia, h...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-017-0857-7
更新日期:2017-06-01 00:00:00
abstract::Patients with diabetes mellitus are at particularly high risk for cardiovascular disease. Although global risk factor scoring systems, such as the Framingham Risk Score, are well established for screening asymptomatic adults, they are not as predictive in diabetics. Therefore, there has been considerable interest in n...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-013-0358-2
更新日期:2013-05-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this report is to describe the main aspects of sex-related differences in non-ischemic dilated cardiomyopathies (DCM), focusing on chemotherapy-induced heart failure (HF) and investigating the possible therapeutic implications and clinical management applications in the era of personalized ...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-020-01377-z
更新日期:2020-08-08 00:00:00
abstract:PURPOSE OF REVIEW:Cell therapy for cardiovascular diseases is regarded as a rapidly growing field within regenerative medicine. Different cellular populations enriched for cardiac progenitor cells (CPCs), or derivate a-cellular products, are currently under preclinical and clinical evaluation. Here, we have reviewed th...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-018-1031-6
更新日期:2018-08-13 00:00:00
abstract::Diastolic dysfunction in patients with hypertension may present as asymptomatic findings on noninvasive testing, or as fulminant pulmonary edema, despite normal left ventricular systolic function. Up to 40% of hypertensive patients presenting with clinical signs of congestive heart failure have normal systolic left ve...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-001-0071-4
更新日期:2001-11-01 00:00:00
abstract:PURPOSE OF REVIEW:This review describes the effects of psychological stress on the physiology of the entire vascular system, from individual cellular components to macrovascular and microvascular responses, and highlights the importance of the vascular system in the context of current limitations in cardiac imaging for...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-020-01406-x
更新日期:2020-10-09 00:00:00
abstract::Four non-communicable diseases-cardiovascular disease, chronic respiratory disease, diabetes mellitus, and cancer-account for over 60 % of all deaths globally. In recognition of this significant epidemic, the United Nations set forth a target of reducing the four major NCDs by 25 % by 2025. Cardiovascular disease alon...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-015-0679-4
更新日期:2016-01-01 00:00:00
abstract::The Fontan operation has been nothing short of revolutionary in its influence on the modern management of patients born with functionally univentricular hearts. The vast majority of these individuals are now surviving well into adulthood. In the 45 years since its introduction, however, there has been increasing recog...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-016-0716-y
更新日期:2016-05-01 00:00:00
abstract:PURPOSE OF REVIEW:This review discusses the benefits of a completely percutaneous approach to endovascular aortic aneurysm repair (EVAR), and provides an outline as to how this is performed by a multidisciplinary team of cardiologists and cardiovascular surgeons at a quaternary care community hospital. RECENT FINDINGS...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-018-1023-6
更新日期:2018-07-26 00:00:00
abstract::Exercise intolerance in patients with chronic heart failure (CHF) shows no correlation to the degree of left ventricular dysfunction. This surprising finding has directed attention to peripheral changes in CHF: reduced endothelium-dependent vasodilation and altered skeletal muscle metabolism. Physical exercise trainin...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-999-0041-9
更新日期:1999-05-01 00:00:00
abstract::Hypertension is one of the leading causes of death and disability in developing countries. The increasing burden of hypertension in these countries has been attributed to several indicators of economic progress such as increased life expectancy, urbanization and its attendant lifestyle changes, and the overall epidemi...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-006-0096-9
更新日期:2006-11-01 00:00:00
abstract::Basic and animal research implicate inflammatory mechanisms in the pathogenesis and progression of atherosclerosis, plaque rupture, thrombosis, and stroke. Inflammatory biomarkers, particularly high-sensitivity C-reactive protein and lipoprotein-associated phospholipase A2, have been identified as potential predictors...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-009-0003-2
更新日期:2009-01-01 00:00:00
abstract::A number of reports demonstrate the importance of serum triglyceride values in predicting the clinical onset of vascular disease. However, adjustment for measurements highly correlated with triglyceride (TG) levels, such as history of diabetes, body mass index, and high-density lipoprotein cholesterol (HDL-C), lessen ...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-001-0060-7
更新日期:2001-09-01 00:00:00
abstract::Primary aldosteronism with a prevalence of 8 % of hypertension and 20 % of pharmacologically resistant hypertension is the most common secondary cause of hypertension. Yet, the diagnosis is missed in the vast majority of patients. Current clinical practice guidelines recommend screening for primary aldosteronism in pa...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-016-0774-1
更新日期:2016-10-01 00:00:00
abstract::Hypertension in patients with renovascular disease poses a major clinical challenge. Renal arterial disease accelerates hypertension by activation of multiple pressor systems. Although younger individuals with fibromuscular lesions often respond well to angioplasty with minor associated risks, care must be taken in ca...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/BF02938389
更新日期:2007-11-01 00:00:00
abstract::Aortic stenosis affects many people worldwide with a significant impact on morbidity and mortality with uncorrected, symptomatic aortic valve stenosis carrying mortality of 50% at one year. Degenerative calcific pathology, the most common cause of aortic stenosis, increases in prevalence with age; estimated prevalence...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-013-0367-1
更新日期:2013-06-01 00:00:00
abstract::Controlled clinical trials, performed in more than 13,000 patients, have consistently shown the beneficial effects of long-term beta-blocker therapy in patients with chronic heart failure. However, it is not clear whether this is a class effect or if it is specific only for some agents. Beneficial effects on the progn...
journal_title:Current cardiology reports
pub_type: 杂志文章
doi:10.1007/s11886-000-0076-4
更新日期:2000-05-01 00:00:00
abstract:PURPOSE OF REVIEW:This review presents the current available evidence of the effects of several dietary patterns on atherosclerotic cardiovascular disease (ASCVD) risk in patients with type 2 diabetes (T2D). RECENT FINDINGS:Evidence demonstrates improvements in cardiovascular risk factors with some dietary patterns in...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-019-1232-7
更新日期:2019-10-17 00:00:00
abstract:PURPOSE OF THE REVIEW:Moderate or severe aortic regurgitation (AR) occurs in 0.5% of the population and typically peaks in the fourth to sixth decade of life. A significant proportion of patients have prohibitive surgical risk and are therefore treated medically with pharmacological management of heart failure and no d...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-020-01338-6
更新日期:2020-07-28 00:00:00
abstract::Medical management of patients with atrial fibrillation (AF) at high risk for stroke is limited by problems of imperfect tools for assessment of thromboembolism and bleeding risks. Improved instruments, such as the CHA₂DS₂VASc and HAS-BLED risk stratification scores, have been incorporated into European practice guide...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-010-0148-z
更新日期:2011-02-01 00:00:00
abstract::Diabetes mellitus (DM) is a metabolic disorder of multiple etiologies that causes long-term damage of various organs including the cardiovascular system. A consistent observation shows that DM amplifies the risk of cardiovascular events by 4- to 6-fold. Since coronary artery disease (CAD) in diabetic patients exhibits...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-012-0323-5
更新日期:2013-01-01 00:00:00
abstract:PURPOSE OF REVIEW:The review is focused on "digital health", which means advanced analytics based on multi-modal data. The "Health Care Internet of Things", which uses sensors, apps, and remote monitoring could provide continuous clinical information in the cloud that enables clinicians to access the information they n...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-018-0990-y
更新日期:2018-05-10 00:00:00
abstract::Lifestyle modification is primary in cardiovascular (CV) disease prevention. A major contribution is the Mediterranean diet (MedDiet), defined by two of seven components. Italian investigators determined a significant decrease in peripheral arterial disease of 56 % for a high score. Multiple specific CV risk factors a...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-014-0491-6
更新日期:2014-01-01 00:00:00
abstract::There are a number of limitations associated with conventional mapping for ablation of ventricular tachycardia (VT) in ischemic heart disease, such as the high recurrence rates after initially successful ablation. The development of a noncontact mapping system capable of producing high-resolution isopotential maps of ...
journal_title:Current cardiology reports
pub_type: 杂志文章,评审
doi:10.1007/s11886-000-0038-x
更新日期:2000-11-01 00:00:00