Gender differences in heart disease

Question 1

Number 1 killer of women?

Answer 1

Heart disease

Question 2

What does HFpEF stand for?

Answer 2

Heart failure with preserved ejection fraction

Question 3

What is HFpEF?

Answer 3

Complex condition
No proven treatment
Associated with poor quality of life an depression
Underdetected due to lack of biomarker and tests

Question 4

Lifetime risk of developing CAD in women?

Answer 4

1/2

Question 5

Men have more risk of getting MI and re-infarctions. True or flase?

Answer 5

False. Women are more likely to get it

Question 6

Reasons for worse cardiovascular outcomes in women?

Answer 6

Atypical and delayed presentation and diagnosis
Lack of awareness of risk and symptoms in women
Assessment bias- less likely to get referrals
Biological bias- gender differences in drug responses and vessel sizes
Higher procedural complication rates

Question 7

Structural features of CAD in women?

Answer 7

Smaller size
Increased stiffness of vessel (fibrosis remodeling)
More diffuse disease

In younger women-
More plaque obstruction less obstructive disease coronary dissection

Question 8

Functional features of CAD in women?

Answer 8

Endothelial dysfunction
Smooth muscle dysfunction
Inflammation

Question 9

Pathophysiology of IHD in women?

Answer 9

Estradiol
       |
Hypertension, hyperlipidemia, obesity 
       |
Inflammatory milieu 
       |
Positive coronary remodelling + Abnormal coronary reactivity

Question 10

Positive coronary remodelling?

Answer 10

Increased wall thickness, plaque erosion, distal embolization

Question 11

Abnormal coronary reactivity?

Answer 11

Microvascular dysfunction
Endothelial dysfunction
Metabolic changes
Decreased perfusion

Question 12

Statistics of woman who get chest pain in a heart attack?

Answer 12

1/8

Question 13

Symptoms which both men and women get in heart attacks?

Answer 13

Chest pain
Pressure
Aching
Tightness

Question 14

Atypical symptoms (but typical in women)

Answer 14

• Milder symptoms (without chest pain) normally in younger women
• Shortness of breath
• Sudden onset of weakness
• Fatigue, body aches or overall feeling of illness
• Unusual feeling of mild discomfort in back, arm, chest, neck or jaw
• Heartburn, nausea, vomiting, abdominal pain
• Symptoms may occur up to a week before MI- fatigue, sleep disturbance, SOB, anxiety, indigestion, palpitations

Question 15

Types of risk factors in women for Atherosclerotic Cardiovascular Disease?

Answer 15

Modifiable
Non-modifiable
Emerging risk

Question 16

Non modifiable risk factors for Atherosclerotic Cardiovascular Disease?

Answer 16

Family history
Age
Gender

Question 17

Modifiable risk factors for Atherosclerotic Cardiovascular Disease?

Answer 17

High BP
Dyslipideamia 
Diabetes 
Smoking 
Obesity and overweight 
Physical Inactivity

Question 18

Emerging risk factors for Atherosclerotic Cardiovascular Disease?

Answer 18

Preterm delivery 
Hypertensive disorders of pregnancy 
Gestational diabetes 
Autoimmune disease 
Early menopause 
Depression

Question 19

______increases risk of heart disease __ fold regardless of ___.

Answer 19

Inactivity
2
BMI

Question 20

____ doubles the risk of a second heart attack in ____ but not in ____.

Answer 20

Diabetes
Women
Men

Question 21

What does hypertensive disease in pregnancy and pre- eclampsia increase risk of?

Answer 21

High blood pressure

Cardiovascular disease

Question 22

Female specific risk factors fro CVD?

Answer 22

Gestational diabetes
Autoimmune conditions- rheumatoid arthritis
Depression- other forms of mental stress
Low socioeconomic status

Question 23

What happens to the incidence of CVD and adverse outcomes after menopoause?

Answer 23

Increases exponentially