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Jul 01, 2014

Advances in Diagnosis of Heart Disease in Women

Gender-specific research has led to significant advancements in the diagnosis of heart disease in women, according to a recent statement.

Thanks to gender-specific research, we can more readily detect heart disease in women, according to a recent statement released by the American Heart Association.

This statement provided a much-needed update to the 2005 guidelines regarding the diagnosis of heart disease in women. Since 2005, authors state that there has been “abundant evidence” to help guide diagnostic testing in women, which was thoroughly reviewed and included in the update. The goal of their statement was to provide doctors with guidelines for when and how to test women for heart disease, based on the latest evidence.

And here’s what every patient should know about these updates to the 2005 guidelines regarding the diagnosis of heart disease in women:

  • Historically, heart disease has gone undetected in many women. Compared to men, research now shows that women have a non-obstructive form of heart disease, which can’t be detected using traditional tests. 

  • Women often experience different symptoms from coronary heart disease compared to men. Not only do women experience a broader list of symptoms, like nausea and fatigue, they may experience pain in the arms and neck rather than the chest.

  • Tests referred to as CMR (cardiac magnetic resonance imaging) and CCTA (coronary computed tomographic angiography) can provide useful and unique information to help detect heart disease in women. While these tests were considered research techniques in 2005, they have become more commonplace in everyday practice in recent years.

  • Whether a woman should undergo testing for heart disease and what type of test is most appropriate depends on whether the patient is considered low, intermediate or high risk for heart disease. Most women considered low-risk for heart disease should not undergo testing. The AHA recommends that those with low or intermediate risk who warrant testing first undergo a treadmill exercise electrocardiogram and those at high risk may need to undergo cardiac magnetic resonance imaging (MRI) or computed tomography (CT) angiography. However, authors recommend that women always discuss the pros and cons of diagnostic tests with their doctor.

Questions for You to Consider

  • What is the difference between obstructive and nonobstructive heart disease?
  • Coronary artery disease (also called coronary heart disease or heart disease) is a term used to describe the narrowing of the arteries inside the heart due to the build up of plaque, known as atherosclerosis. With obstructive heart disease, the build-up of plaque in the arteries can slow or stop the flow of blood to the heart. With nonobstructive heart disease, called coronary microvascular disease (MVD), there is damage to the blood vessels that branch off from the larger coronary arteries. Women develop nonobstructive heart disease more often than men and diagnosing this condition can be a challenge, since standard tests are not designed to detect this microvascular disease.
  • What are the signs and symptoms of coronary microvascular disease?
  • The most common signs of coronary microvascular disease (also called nonobstructive coronary heart disease) include chest pain, shortness of breath, sleep problems, fatigue and a lack of energy. Most often, patients experiencing these symptoms first notice them during times of mental stress or during physical activity.


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