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Other diagnostic considerations

Consider:

1) What does atypical chest pain really mean in women?

2) Sex and gender differences: women and men have different biological and hormonal status, as well as social realities that shape lifestyle, perception of the disease and interaction with the health care system

3) As health care providers we may have biases that lead to different approaches to men and women that we may not be aware of but may influence our care and aaproach to a woman with possible or suspected CAD.

Modena[5] suggests a more individualized approach to diagnosing CAD in women that includes taking the pre-test probability of disease into account. The first step suggested is the exercise ECG.  If this is not possible or uninterpretable, an imaging and/or pharmacological stress test should be considered. If the exercise ECG is positive, coronary angiography is indicated.

 

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5. Modena MG, Nuzzo A, Rossi R, Gender differences in diagnostic procedures, Italian Heart Journal: Official Journal of the Italian Federation of Cardiology. 4(8):518-21, 2003

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