Cardiovascular disease in women: heart disease across the life span.

Women are more likely to have atypical cardiovascular symptoms compared with men. This may lead to delayed diagnosis of coronary artery disease (CAD) and suboptimal treatment. The exercise stress test is the initial test for women with suspected or known CAD. The addition of imaging (eg, echocardiography, nuclear medicine, computed tomography scan, magnetic resonance imaging) to the exercise component may improve the diagnostic value of the test. Drugs used to manage CAD in women include antiplatelets, beta blockers, lipid-lowering drugs, angiotensin-converting enzyme inhibitors, calcium channel blockers, and nitrates. Invasive therapy with angioplasty or bypass surgery is performed less frequently in women than in men. Women may present with acute coronary syndrome and atypical symptoms. Initial treatment should be the same for men and women. Takotsubo cardiomyopathy is a rare condition that is seen more frequently in older, postmenopausal women.