Key result
Emerging conditions like SCAD and MSIMI in young women require improved recognition to prevent misdiagnosis.
Why the study?
CVD mortality in young women <55 years old remains significantly high, yet awareness is lacking and traditional CVD risk tools often fail to identify at-risk young females.
Increased awareness and recognition of MINOCA, SCAD, and MSIMI in young women are necessary to prevent misdiagnosis and improve clinical outcomes.
Answers are grounded in this paper and cite their sources.
Improved recognition of SCAD and MSIMI may reduce misdiagnosis in young women; leaves open prospective validation of educational interventions.
BACKGROUND: Cardiovascular disease (CVD) remains the leading cause of death for females in the United States accounting for over 412 000 female deaths in 2016. CVD mortality in young women <55 years old remains significantly high and greater than that in men. HYPOTHESIS: There is a void with regards to awareness of CVD in women. Many traditional CVD risk estimate tools fail to identify the "at risk" female and is true for the young female patient. There needs to be a shift in focus from looking for the vulnerable plaque to looking for the "at risk" patient. METHODS: This review outlines the emerging misunderstood presentations of CVD in young women which include certain categories of myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA), such as spontaneous coronary artery dissection (SCAD), as well as the more stable myocardial ischemia with non-obstructive coronary arteries (INOCA) category focusing on mental stress-induced myocardial ischemia (MSIMI). RESULTS: The prevalence of MINOCA in patients presenting with MI is greater in women. In younger women with CVD, SCAD is an emerging misunderstood presentation in this group of patients with type 2 SCAD being the most common form. MSIMI, a form of INOCA, is more common in women with CVD. CONCLUSIONS: There are emerging misunderstood factors that are prevalent in young women, such as SCAD and MSIMI. It is important to recognize their presentations in young women to prevent misdiagnosis, missed diagnosis as well as mismanagement of these patients to improve their clinical outcomes.
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Bullock-Palmer et al. (2019) conducted a review in Cardiovascular disease. Emerging misunderstood presentations of cardiovascular disease in young women, such as SCAD and MSIMI, require improved recognition to prevent misdiagnosis and improve clinical outcomes.
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