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Myocardial infarction is uncommon in younger women in the absence of coronary risk factors; cigarette smoking and diabetes mellitus are major contributors to coronary risk. The presentation of coronary disease in women is more likely to be angina pectoris than myocardial infarction or sudden death. Myocardial infarction in women is characterized by increased morbidity and mortality, an excess of congestive heart failure, and a less favorable response to coronary bypass surgery. Psychosocial complications are greater and return to work is less likely. Introduction In women, especially those under the age of 50, coronary artery disease is unusual in the absence of diabetes or hypertension. Yet precordial pain simulating angina pectoris is a very common symptom. E. P. Boas and H. Levy 1936 (I) These astute clinical observations, reported almost half a century ago, appear altered in the 1980s as a consequence of the widespread adoption of cigarette smoking by women, as well as their use of oral contraceptive drugs. Nevertheless, there remains a high prevalence of coronary risk factors among young women who sustain a myocardial infarction. Although clinical evidence of atherosclerotic coronary heart disease is less common among women than among men of comparable age, coronary disease
Annual Review of Medicine – Annual Reviews
Published: Feb 1, 1985
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