TY - JOUR
T1 - Noninvasive Evaluation of Symptomatic Women with Suspected Coronary Artery Disease
AU - Chamsi-Pasha, Mohammed A.
AU - Kurrelmeyer, Karla M.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Cardiovascular disease (CVD) is the leading cause of death in the United States, yet several factors make it challenging to diagnose in women. Although women have more frequent chest pain than men, atypical symptoms such as nausea, dyspnea, and fatigue make it difficult to determine their risk of coronary artery disease (CAD) before testing. Current guidelines recommend exercise electrocardiography (ex-ECG) as the initial test in symptomatic women with intermediate pretest probability who can exercise and have a normal resting ECG; however, treadmill ex-ECG testing has a significantly lower positive predictive value in women. In addition, women often have nonobstructive CAD in conjunction with microvascular dysfunction and other cardiovascular abnormalities that can decrease the accuracy of all noninvasive tests. The following provides an overview of exercise ECG, echocardiography, SPECT imaging, and various other available modalities and examines their effectiveness in diagnosing and managing symptomatic women with suspected CAD.
AB - Cardiovascular disease (CVD) is the leading cause of death in the United States, yet several factors make it challenging to diagnose in women. Although women have more frequent chest pain than men, atypical symptoms such as nausea, dyspnea, and fatigue make it difficult to determine their risk of coronary artery disease (CAD) before testing. Current guidelines recommend exercise electrocardiography (ex-ECG) as the initial test in symptomatic women with intermediate pretest probability who can exercise and have a normal resting ECG; however, treadmill ex-ECG testing has a significantly lower positive predictive value in women. In addition, women often have nonobstructive CAD in conjunction with microvascular dysfunction and other cardiovascular abnormalities that can decrease the accuracy of all noninvasive tests. The following provides an overview of exercise ECG, echocardiography, SPECT imaging, and various other available modalities and examines their effectiveness in diagnosing and managing symptomatic women with suspected CAD.
KW - coronary artery disease
KW - exercise ECG
KW - ischemic heart disease
KW - stress test
KW - women
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U2 - 10.14797/mdcj-13-4-193
DO - 10.14797/mdcj-13-4-193
M3 - Review article
C2 - 29744011
AN - SCOPUS:85052199785
VL - 13
SP - 193
EP - 200
JO - Methodist DeBakey cardiovascular journal
JF - Methodist DeBakey cardiovascular journal
SN - 1947-6094
IS - 4
ER -