ACS & women

Q: In the management of acute coronary syndrome (ACS), which gender has a higher risk of bleeding? 

A) Men

B) Women

Answer: B

Although in the management of acute coronary syndrome, the approach to women and men is the same, at least five things should be remembered that women:

• have more atypical symptoms
• are older
• have more significant delays to presentation
• have a higher prevalence of hypertension (HTN)
• have a higher risk of bleeding

Often due to gender bias, common diagnoses get missed, such as myocarditis and aortic dissection.

At least there is one study which found that stress-induced cardiomyopathy (takotsubo cardiomyopathy) may occur in up to 6 percent of women who present with ACS (reference # 2).

#cardiology

References:

1. Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 130:2354.

2. Sy F, Basraon J, Zheng H, et al. Frequency of Takotsubo cardiomyopathy in postmenopausal women presenting with an acute coronary syndrome. Am J Cardiol 2013; 112:479.