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Current Standards for Screening Women with Heart Disease May not be Sufficient - Angiograph Misses Coronary Microvascular Dysfunction

January 31st 2006

Current Standards for Screening Women with Heart Disease May not be Sufficient - Angiograph Misses Coronary Microvascular Dysfunction


Women are different than men when it comes to heart disease.  According to a new study cholesterol plaque may not build up into major blockages in women.  In stead, the plaque builds up “evenly” throughout the artery.  A coronary angiography may indicate the woman has “clear” arteries (i.e. No blockages).  This may be incorrect.

Women may undergo screening and have a clean bill-of-health, or at least be at low risk, when they are actually at a high risk “for heart attack”, according to a newly published research paper from the National Institutes of Health. The plaque will accumulate in the small arteries of the heart (coronary microvascular dysfunction), causing a narrowing of the arteries and a reduction in oxygen flow to the heart.  There may be a pain similar to that of people with blocked arteries, even though plaque does not show up on the standard tests.  In this case, women will go undiagnosed.


Investigators from the National Heart, Lung, and Blood Institute’s (NHLBI) Women’s Ischemia Syndrome Evaluation (WISE) study have determined that these standard tests are not sufficient in determining whether a woman has heart disease or not.  Their findings are published in the February 6 issue of the Journal of the American College of Cardiology, available online January 31.

According to NHLBI Director Elizabeth G. Nabel, M.D, we need to start thinking outside the box when it comes to evaluation and diagnosis of heart disease in women.  She said “When a diagnosis of this condition is missed, women are not treated for their angina and high cholesterol and they remain at high risk for having a heart attack.”


According to C. Noel Bairey Merz, Cedars-Sinai Medical Center and the WISE study chairperson, “So much of our understanding of the underpinnings of heart disease and heart attack, and the basis for our standard methods of diagnosis and treatment are the result of research conducted on men.”  He says the disease “may manifest differently in women.”  We may need to develop new diagnostic techniques in order to prevent more heart attacks and save lives.

Many women that are given a clear angiography who are not diagnosed may continue to have symptoms and a declining quality of life.  According to a recent ABC News report, the “Gold Standard” for determining whether women have heart disease is not sufficient.  The WISE study has provided the groundwork for additional controlled clinical studies of diagnostic tools and treatments in women with ischemic (artery blockage) heart disease.

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By Dan Wilson
Best Syndication Staff Writer

Books on Heart Disease

Keywords and misspellings:  coranary micro-vascular disfunction iscemic iskemic ishcemic ishcemia angiograf blood presure stroke embolism imbolism embilism embelism bloode clot

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Copyright 2005 Best Syndication                                            Last Updated Saturday, July 10, 2010 09:49 PM