Acute coronary syndromes across the lifespan of women

Figures

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  Fig. 1. Acute coronary syndromes in women across the lifespan. Representative ACS phenotypes, key risk factors, and clinical modifiers by age group in women, from childhood through older adulthood. ACS acute coronary syndrome, CVD cardiovascular disease, FH familial hypercholesterolemia, MINOCA myocardial infarction with non-obstructive coronary arteries, SCAD spontaneous coronary artery dissection, SLE systemic lupus erythematosus.

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  Fig. 2. Pathophysiologic mechanisms of acute coronary syndromes in women. Women experience acute coronary syndrome (ACS) through both obstructive and non-obstructive mechanisms, with notable age-based variability. Atherothrombotic causes such as plaque rupture, erosion, and calcific nodules predominate in postmenopausal and older women, while non-obstructive causes, including spontaneous coronary artery dissection (SCAD), coronary vasospasm, microvascular dysfunction, and coronary embolism, are disproportionately represented in women under age 60. Mechanisms may coexist or evolve across the lifespan. MINOCA myocardial infarction with non-obstructive coronary arteries.