title: Sex-specific factors in microvascular angina.
abstract: In women presenting for evaluation of suspected ischemic symptoms, a diagnosis of normal coronary arteries is 5 times more common than it is in men. These women are often labelled as having cardiac syndrome X, and a subset of them have microvascular angina caused by microvascular coronary dysfunction (MCD). MCD is not benign and is associated with an annual 2.5% cardiac event rate. Noninvasive testing for MCD remains insensitive, although newer imaging modalities, such as adenosine cardiac magnetic resonance imaging, appear promising. The gold standard for diagnosis of MCD is coronary reactivity testing, an invasive technique that is not available in many countries. With regard to treatment, large-scale trials are lacking. Although research is ongoing, the current platform of therapy consists of antiangina, antiplatelet, and endothelium-modifying agents (primarily angiotensin-converting enzyme inhibitors and statins).
authors.affiliation: Vancouver General Hospital, Vancouver, British Columbia, Canada.|Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Tara
authors.initials: T
authors.lastname: Sedlak
authors.affiliation: Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Mona
authors.initials: M
authors.lastname: Izadnegahdar
authors.affiliation: Providence Health Care Research Institute, St. Paul's Hospital, Vancouver, British Columbia, Canada.|Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Karin H
authors.initials: KH
authors.lastname: Humphries
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA.
authors.forename: C Noel
authors.initials: CN
authors.lastname: Bairey Merz
mesh_terms: D000367:Age Factors; D003331:Coronary Vessels / Q000503:physiopathology*; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D014943:Global Health; D006801:Humans; D008297:Male; D017566:Microvascular Angina / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D009017:Morbidity / Q000639:trends; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014661:Vasoconstriction / Q000502:physiology*