Coronary artery disease in females

INTRODUCTION : Coronary heart disease has been defined as “impairment of heart function due to inadequate blood flow to the heart compared to its needs, caused by obstructive changes in the coronary circulation to the heart”. Coronary heart disease is assuming serious dimension in developing countries. It is expected to be the single most important cause of death in India by the year 2015. Coronary artery disease is the leading cause of death among women, regardless of race or ethnicity and causing the deaths of 1 in 3 women than from stroke, lung cancer, chronic obstructive lung disease, and breast cancer combined. Women with coronary artery disease present differently than men, have different pathophysiologies and risks profiles and are often significantly older and thus often have poorer outcomes. Experts in industrialized societies have long recognized that the first presentation with coronary heart disease occurs approximately 10 years later among women than men, most commonly after menopause. Although coronary artery disease in general manifests earlier in less well-developed countries, the approximate 8 to 10 years age gap in time of onset between men and women is universal. Despite this delay in onset, mortality from coronary heart disease is increasing more rapidly among women than men from both developed and developing world. AIM OF STUDY : 1. This study is to find the various modes of presentation and clinical profile of coronary artery disease in females. 2. To study the associated risk factors, there is an urgent need to recognize all these conditions so as to reduce the burden associated with it in terms of increased morbidity and mortality. OBJECTIVE : 1. To find the various modes of presentation and clinical profile of coronary artery disease in females 2. To study the associated risk factopors METHODOLOGY : Design: Prospective cross sectional study. Place: Coimbatore Medical College Hospital, Coimbatore, Tertiary Care Hospital. Period of study: September 2010 to June 2011. Inclusion criteria : 1. Patients above 40 years, 2. Hypertension, 3. Diabete mellitus, 4. Dyslipidemia. Exclusion criteria: 1. Congenital heart disease, 2. Rheumatic heart disease, 3. Structural heart disease, 4. Electrical abnormalities. Subjects: 100 female patients admitted with symptoms, signs and ECG changes suggestive of CAD with biochemical markers taken as cases. RESULTS : In this study, 33% were among age group between 60 - 70 years. Coronary artery disease mortality among women gradually increases with age and increase in the risk of coronary artery disease is related to a higher incidence of hypertension, diabetes, obesity, and dyslipidemia. CONCLUSION : 1. The most common presentation is chest pain. 2. Waist-hip ratio associated with obesity and overweight increases the risk of myocardial infarction in female populations. 3. Most common presentation is STEMI. 4. Systemic hypertension, diabetes mellitus also associated with increased trisk of MI