医学
冠状动脉疾病
部分流量储备
缺血
心肌灌注成像
磁共振成像
心脏病学
疾病
放射科
心脏成像
内科学
心肌梗塞
冠状动脉造影
作者
Purvi Parwani,Adeba Mohammad,Y. Liberman,Diana Litmanovich
出处
期刊:Journal of Thoracic Imaging
[Ovid Technologies (Wolters Kluwer)]
日期:2023-05-26
被引量:2
标识
DOI:10.1097/rti.0000000000000719
摘要
Approach to imaging ischemia in women Coronary artery disease in women tends to have a worse short- and long-term prognosis relative to men and remains the leading cause of mortality worldwide. Both clinical symptoms and diagnostic approach remain challenging in women due to lesser likelihood of women presenting with classic anginal symptoms on one hand and underperformance of conventional exercise treadmill testing in women on the other. Moreover, a higher proportion of women with signs and symptoms suggestive of ischemia are more likely to have nonobstructive coronary artery disease (CAD) that requires additional imaging and therapeutic considerations. New imaging techniques such as coronary computed tomography (CT) angiography, CT myocardial perfusion imaging, CT functional flow reserve assessment, and cardiac magnetic resonance imaging carry substantially better sensitivity and specificity for the detection of ischemia and coronary artery disease in women. Familiarity with various clinical subtypes of ischemic heart disease in women and with the major advantages and disadvantages of advanced imaging tests to ensure the decision to select one modality over another is one of the keys to successful diagnosis of CAD in women. This review compares the 2 major types of ischemic heart disease in women – obstructive and nonobstructive, while focusing on sex-specific elements of its pathophysiology.
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