Ischemic heart disease in women

Although cardiovascular (CV) disease is the leading cause of death in women, both the women and physician’s awareness on the prevalence and the prognosis of CV disease in women is not sufficient. Women have diffuse microvascular dysfunction rather than obstructive coronary artery disease (CAD). Therefore, in women “ischemic heart disease (IHD)” term is preferred to CAD. Despite the fact that the prevalence and the severity of anatomic CAD is lower in women that men, women have more symptom load, more functional loss, more expenses of health, and negative clinical outcomes. The frequent detection of normal coronaries in women with atypical but resistant symptoms, leads the physicians to misconception that these women have “no severe problem” or “no need for treatment”. Therefore, the diagnosis, treatment, and preventive initiatives of IHD are not properly applied in women. Moreover, as women are less represented in clinical trials, data on women are also not sufficient. This review is written to raise the awareness of physicians about the prevalence, prognosis, diagnostic methods and treatment alternatives of IHD in women.