Cardiovascular disease is the leading cause of death in women. Ischemic heart disease, due to the protective effect of estrogen, usually appears in postmenopausal women and, Thus, much later than men. Women with acute coronary syndrome have typical pain in the same proportion as men; Nevertheless, the presence of atypical pain, which it is usually associated with a lower incidence of coronary lesions, It is more common in women; in this context, the sensitivity and specificity of noninvasive tests for the diagnosis of ischemic heart disease is discussed. clinical features are described, treatment and prognosis of acute coronary syndromes in women, and the importance of age and severity of the clinical presentation in the high mortality of acute myocardial infarction in women is highlighted.
ischemic heart disease in women is usually presented in postmenopausal women and, Thus, at least a decade later than in men. Although the most important cause of mortality among women is cardiovascular diseases, a significant percentage of them do not know this reality. In a survey conducted in the United States, a large majority of women between 25 and 44 years I believed that breast cancer was the leading cause of death among them1. In general, The Company believes that this disease is a health problem that mainly affects males.
Specific, in the year 1998, cardiovascular diseases accounted for 37% of all deaths in Spain, and they corresponded to 34% of deaths in men and 43% in women2. The condition of the vascular territory also differs regarding sex. Of all cardiovascular deaths in men, the 37% They were secondary to ischemic heart disease and 26% a cerebrovascular disease, the 25% because of other cardiovascular diseases and 12% It was due to heart failure. Conversely, In the women, cerebrovascular disease was the cause of 31% deaths, followed by ischemic heart disease in the 24% of the cases, secondary to other cardiovascular diseases in the 26% and heart failure in the 19%. He 61% of deaths from ischemic heart disease in women they are due to acute myocardial infarction. In the table 1 the estimated number of cases of acute myocardial infarction and fatal total in men and women for the year shown 2002 in Spain, depending on the age of patients. It is observed that men have a greater number of heart attacks in the age group 25-74 years old, Meanwhile he 70% of cases occur in women age group > 75 years old, with total mortality 28 days in this age group 76%, no apparent differences between the sexes.