Coronary Atherosclerosis The Implications of Being a Woman
The profile of ischemic heart disease by coronary atherosclerosis has been developed based on clinical,
paraclinical and angiographic grounds inherent to the male gender. A man in his 40s - 50s with "classical” cardiovascular
risk factors, angina pectoris and hemodynamically significant myocardial ischemia associated with angiographic stenosis
(≥ 50% endovascular diameter reduction equivalent to ≥ 75% endovascular area reduction and determining a transstenotic
pressure gradient) is the prototype over which guidelines for prevention, diagnosis and treatment of this disease
are structured. However, this "male" pattern of coronary atherosclerosis is not the rule in female gender. Therefore, in
women, the frequent lack of a clinical, paraclinical and angiographic profile, classically masculine, results in a suboptimal
medical approach, characterized by low implementation of the guidelines for prevention, diagnosis and treatment of
ischemic heart disease. The final consequence of this cycle, favored by other gender, social and environmental
circumstances, is a high morbidity and mortality caused by this pathology in the female gender.
In this chapter, which concludes with a review of the state-of-the-art knowledge of atheroma in females, the current
concepts on the physiological level of c-LDL, oxidized c-LDL "a mimicked pathogen" and atherogenesis will be reviewed
in sequence for didactic purposes.
Keywords: Atherogenesis, atheroma-in-females, coronary-angiography, coronary-angiotomography, coronary-atherosclerosis,
coronary-ultrasound, ischemic-heart-disease, LDL-physiological-level, oxidized-LDL.
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