New Findings May Change The Way Heart Disease Is Detected And Treated In Women, From The 'Harvard Women's Health Watch'

Results of a landmark study
suggest that many women with heart disease don't get a proper diagnosis
because they have a form of the disease that doesn't show up on the usual
diagnostic tests. The new research shows that heart disease is not one but
several disorders and may shed light on why heart disease often behaves
differently in men and women, according to the February 2007 issue of
"Harvard Women's Health Watch."


In the Women's Ischemia Syndrome Evaluation (WISE) study, women with
chronic chest pain underwent standard diagnostic procedures, including
stress tests and coronary angiograms. Earlier studies had found that among
people who show signs of trouble on stress tests, women are far more likely
than men to appear free of blockages on follow-up angiograms. This was also
true in the WISE study. But newer tests, including ultrasound of the blood
vessels, revealed heart problems the angiograms didn't pick up. Many of
these women had a condition called vascular dysfunction, in which the blood
vessels supplying the heart don't expand properly to accommodate increased
blood flow. Vascular dysfunction may affect not only the large coronary
arteries, but also the smaller vessels that serve the heart -- a problem
dubbed microvessel disease.



The WISE results may help explain why women with heart disease are
often underdiagnosed and undertreated. In men, the main problem may be a
blockage in a large coronary artery, which shows up on an angiogram, while
women are more likely to have microvessel disease that can't be seen. With
this in mind, the WISE investigators are working to develop a new system
for screening women for heart disease.



Harvard Health Publications

health.harvard.edu/women