Utility of Imaging in Risk Stratification of Chest Pain in Women

Abstract

Recent decades have seen a growing recognition that the understanding of sex differences in cardiovascular disease (CVD) is vital to optimal diagnosis and management, particularly of women (Mosca et al. Circulation 124:2145-54, 2011). There is simultaneously an increasing appreciation of the multifactorial nature of ischemic heart disease (IHD) in many patients, in whom disease may extend beyond the epicardial coronaries. While obstructive coronary artery disease (CAD) remains underdiagnosed in women and still represents a major burden of disease, women also present with nonobstructive CAD more commonly than men (Patel et al. N Engl J Med 362:886-95, 2010). Indeed, microvascular dysfunction, coronary artery vasospasm, and coronary dissections contribute to a larger proportion of IHD in women than men (Bairey Merz et al. J Am Coll Cardiol 47:S21-9, 2006). Here, we review the symptom presentation of women with IHD and the noninvasive modalities used to risk stratify women with suspected IHD.

Machine Learning in Stroke Medicine: Opportunities and Challenges for Risk Prediction and Prevention

“…In other words, bias can occur when data sources do not reflect the true epidemiology within a given demographic [75]. As an example, consider that cardiovascular disease is often underdiagnosed in women because their symptoms are described as atypical [85,86]. Using such data to train ML-based algorithms may further reinforce this trend.…”