The Clinical Spectrum of Myocardial Infarction and Ischemia With Nonobstructive Coronary Arteries in Women

• Authors: Nanette Wenger, Emory University; Leslee Shaw, Emory University; IJ van den Hoogen, NewYork Presbyterian Hosp; U Gianni, NewYork Presbyterian Hosp; MJ Wood, Massachusetts General Hospital; VR Taqueti, Harvard Medical School; FY Lin, NewYork Presbyterian Hosp; SN Hayes, Mayo Clinic; GM Feuchtner, Medical University of Innsbruck; AR van Rosendael, NewYork Presbyterian Hosp; J Wei, Cedars Sinai Med Ctr; CNB Merz, Cedars Sinai Med Ctr; CJ Pepine, University of Florida
• Journal Title: JACC-CARDIOVASCULAR IMAGING
• Volume: Volume 14, Number 5
• Publisher: ELSEVIER SCIENCE INC | 2021-05-03, Pages 1053-1062
• Type of Work: Article
• Publisher DOI: http://doi.org/10.1016/j.jcmg.2020.06.044
• Keywords: Science & Technology; Life Sciences & Biomedicine; Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging; Cardiovascular System & Cardiology; atherosclerosis; coronary microvascular dysfunction; ischemia and no obstructive coronary arteries; INOCA; MINOCA; myocardial infarction with nonobstructive coronary arteries; sex; women; DISSECTION

Abstract

Women exhibit less burden of anatomic obstructive coronary atherosclerotic disease as compared with men of the same age, but contradictorily show similar or higher cardiovascular mortality rates. The higher prevalence of nonexertional cardiac symptoms and nonobstructive coronary atherosclerotic disease in women may lead to lack of recognition and appropriate management, resulting in undertesting and undertreatment. Leaders in women's health from the American College of Cardiology's Cardiovascular Disease in Women Committee present novel imaging cases that may provoke thought regarding the broad clinical spectrum of myocardial infarction and ischemia with nonobstructive coronary arteries in women. These unique imaging approaches are based on the concept of targeting sex-specific differences in acute and stable ischemic heart disease.