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Sex-Specific Differences in Acute Myocardial Infarction

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Gender Differences in the Pathogenesis and Management of Heart Disease

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Abstract

Ischemic heart disease remains the leading cause of death in the United States for both men and women. Since the 1980s medical advancements in prevention and management of ischemic heart disease have dramatically reduced morbidity and mortality. Unfortunately improvements in care have not affected men and women equitably and there remain significant disparities in outcomes post acute myocardial infarction (AMI) when gender is considered. Women have worse outcomes from AMI as compared to men, with younger women experiencing comparatively higher mortality rates. As our knowledge of cardiovascular health continues to develop, we have come to recognize that there are gender differences in AMI presentation, pathophysiology and eventual management. The basis for this can be attributed to both biological differences in pathophysiological mechanisms and also to unequal delivery of care. Women with AMI remain under-recognized and under-treated by the current health care system, despite increasing awareness and advancement in women’s cardiovascular health. This chapter will discuss known and emerging gender differences in pathophysiology, risk factors, clinical presentation, diagnosis, and management of AMI, with aim to educate healthcare providers about ongoing significant disparities. Additional efforts and research are imperative to improving outcomes for women with AMI.

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Acknowledgment

This work was supported by NIH-NHLBI grant K23HL105787 and the Emory Clinical Cardiovascular Research Institute (ECCRI).

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Authors and Affiliations

  1. J. Willis Hurst Internal Medicine Residency Program, Emory University, Atlanta, GA, USA

    An Le-Nguyen Young M.D., M.P.H. & Allyson Herbst M.D.

  2. Emory Women’s Heart Center, Emory University, Atlanta, GA, USA

    Puja K. Mehta M.D., F.A.C.C., F.A.H.A.

  3. Division of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    Bina Ahmed M.D.

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  1. An Le-Nguyen Young M.D., M.P.H.
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  2. Puja K. Mehta M.D., F.A.C.C., F.A.H.A.
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  3. Allyson Herbst M.D.
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  4. Bina Ahmed M.D.
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Correspondence to Puja K. Mehta M.D., F.A.C.C., F.A.H.A. .

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  1. Stebbins Chair in Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Jawahar L. Mehta

  2. College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Jean McSweeney

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Young, A.LN., Mehta, P.K., Herbst, A., Ahmed, B. (2018). Sex-Specific Differences in Acute Myocardial Infarction. In: Mehta, J., McSweeney, J. (eds) Gender Differences in the Pathogenesis and Management of Heart Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-71135-5_11

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