Myocardial Infarction in Women

Abstract

Cardiovascular disease is the leading cause of mortality in the United States regardless of gender. Women infrequently present with myocardial infarction as the initial presentation of coronary heart disease and have unrecognized infarctions more frequently than men. Myocardial infarction in women has a similar clinical presentation as in men, with the exception of an increased incidence of non-Q wave myocardial infarctions. Complications of acute infarction in women are probably similar although the majority of data has been drawn from studies involving predominantly men. Women do however experience more strokes and have less postinfarction pericarditis than their male counterparts. Left ventricular function remains the key prognostic determinant in both sexes. Recurrent infarction is increased in women with resultant elevated mortality rates. However, complex ventricular ectopy following myocardial infarction is not predictive of cardiovascular mortality in women. Early and late survival is decreased in women, an effect probably related to the increase in mean age of women as compared with men. Overall, gender distinctions are not usually made in the majority of studies involving myocardial infarction. As epidemiologic, pathophysiologic and clinical factors may be different regarding heart disease in women, further research in this important area is warranted.