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1

Number 1 killer of women?

Heart disease

2

What does HFpEF stand for?

Heart failure with preserved ejection fraction

3

What is HFpEF?

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

4

Lifetime risk of developing CAD in women?

1/2

5

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

False. Women are more likely to get it

6

Reasons for worse cardiovascular outcomes in women?

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

7

Structural features of CAD in women?

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

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

8

Functional features of CAD in women?

Endothelial dysfunction
Smooth muscle dysfunction
Inflammation

9

Pathophysiology of IHD in women?

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

10

Positive coronary remodelling?

Increased wall thickness, plaque erosion, distal embolization

11

Abnormal coronary reactivity?

Microvascular dysfunction
Endothelial dysfunction
Metabolic changes
Decreased perfusion

12

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

1/8

13

Symptoms which both men and women get in heart attacks?

Chest pain
Pressure
Aching
Tightness

14

Atypical symptoms (but typical in women)

-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

15

Types of risk factors in women for Atherosclerotic Cardiovascular Disease?

Modifiable
Non-modifiable
Emerging risk

16

Non modifiable risk factors for Atherosclerotic Cardiovascular Disease?

Family history
Age
Gender

17

Modifiable risk factors for Atherosclerotic Cardiovascular Disease?

High BP
Dyslipideamia
Diabetes
Smoking
Obesity and overweight
Physical Inactivity

18

Emerging risk factors for Atherosclerotic Cardiovascular Disease?

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

19

______increases risk of heart disease __ fold regardless of ___.

Inactivity
2
BMI

20

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

Diabetes
Women
Men

21

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

High blood pressure
Cardiovascular disease

22

Female specific risk factors fro CVD?

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

23

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

Increases exponentially