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Study: Women with hard to diagnose chest pain symptoms at higher risk for cardiovascular events
Date:5/11/2009

luhm Cardiovascular Institute.

The study analyzed data from two previous studies, the WISE study and the St. James Women Take Heart project, to complete the review. The WISE study examined symptomatic women referred for coronary angiography, or an X-ray examination of the blood vessels or chambers of the heart, and followed them for about five years. The Women Take Heart project enrolled asymptomatic, community-based women with no history of heart disease who were followed for up to 10 years. The prospective study compares cardiovascular events such as heart attack, stroke and hospitalization for heart failure, in 540 WISE study participants with suspected ischemia, or chest pain, but no evidence from medical tests, with those from a group of 1,000 age and race-matched Women Take Heart women.

Compared with the WISE women, the Women Take Heart women had a lower prevalence of obesity, family history of coronary artery disease, hypertension and diabetes. Results showed that over the course of five years, the WISE women had more cardiac events than the Women Take Heart women. The women who experienced the most frequent cardiovascular events were those with four or more cardiac risk factors.

The physicians hypothesize that this difficult to diagnose chest pain could be caused by microvascular angina and endothelial dysfunction, affecting blood vessels in which the layers of the cells are not functioning properly and may be undetectable by standard testing. Researchers believe endothelial dysfunction to be the earliest stage of coronary artery disease.

The study authors recommend that women with chest pain symptoms undergo initial testing for coronary artery disease. If there is no evidence of coronary artery disease, patients should undergo further assessment for endothelial dysfunction. If detected, patients should then undergo treatment to improve the dysfunction. Women with symptoms, but no presence of endothelial dysfunction, s
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Contact: Sally Stewart
Sally.stewart@cshs.org
310-248-6566
Cedars-Sinai Medical Center
Source:Eurekalert

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