Key result
Noninvasive evaluation modalities, including exercise ECG, echocardiography, and SPECT imaging, face unique challenges in diagnosing suspected coronary artery disease in symptomatic women.
Why the study?
Does noninvasive evaluation improve diagnosis and management in symptomatic women with suspected coronary artery disease?
Does noninvasive evaluation improve diagnosis and management in symptomatic women with suspected coronary artery disease?
This review highlights the challenges and effectiveness of various noninvasive imaging modalities in diagnosing coronary artery disease in symptomatic women, who often present with atypical symptoms and microvascular dysfunction.
Requires cautious interpretation of noninvasive tests in women; leaves open need for sex-specific diagnostic strategies.
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.
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Chamsi‐Pasha et al. (2017) conducted a review in Suspected Coronary Artery Disease. Noninvasive evaluation modalities (exercise ECG, echocardiography, SPECT imaging) was evaluated. Noninvasive evaluation modalities, including exercise ECG, echocardiography, and SPECT imaging, face unique challenges in diagnosing suspected coronary artery disease in symptomatic women.
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