This picture comes from an intravascular ultrasound (IVUS) image from inside a heart artery. This is the same kind of technology that is employed in looking at the fetus in a pregant women. The black area in the center is the opening in the artery. It is wide open as you can easily see. There is no blockage at all. The green area is cholesterol plaque and in women with repeated chest pain, this plaque is evenly spread throughout the artery as you can see in the image below. This plaque can rupture or erode and then a clot that blocks the entire artery may occur when the arterial blood comes in contact with the raw surface. That is the way many heart attacks in women occur. That is how they are different.
Bill, this is pretty amazing and explains so much about the differential treatment of heart disease for men and women. Why did it take so long to understand this?
That is a great point Dr. Kibbe. It has been understood for some time. There is an article in the European Heart Journal on the NIH sponsored Women's Ischemic Syndrome Evaluation from 2006 "Persistent Chest Pain Predicts Cardiovascular Events in Women Without Obstructive Coronary Artery Disease" providing evidence on just that. There are dozens of articles on this WISE study. The evidence is there. We have not translated it for the benefit of the women we care about. I will put a link to this paper at the end of today's post. Translating this evidence and providing optimal medical therapy for these women should be a national health priority.
Bill, this is pretty amazing and explains so much about the differential treatment of heart disease for men and women. Why did it take so long to understand this?
That is a great point Dr. Kibbe. It has been understood for some time. There is an article in the European Heart Journal on the NIH sponsored Women's Ischemic Syndrome Evaluation from 2006 "Persistent Chest Pain Predicts Cardiovascular Events in Women Without Obstructive Coronary Artery Disease" providing evidence on just that. There are dozens of articles on this WISE study. The evidence is there. We have not translated it for the benefit of the women we care about. I will put a link to this paper at the end of today's post. Translating this evidence and providing optimal medical therapy for these women should be a national health priority.