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Women who are diagnosed with non cardiac chest pain have twofold increased risk to develop a coronary event in the next 5-7 years and have a four times higher risk for re-hospitalization. This implicates that diagnostic testing is limited and that women should be more aggressively treated for their risk factors. | Women who are diagnosed with non cardiac chest pain have twofold increased risk to develop a coronary event in the next 5-7 years and have a four times higher risk for re-hospitalization. This implicates that diagnostic testing is limited and that women should be more aggressively treated for their risk factors. | ||
Chest pain syndromes are more common in women then in men and are less related to the presence of atherosclerosis in the epicardial coronary arteries.<cite> | Chest pain syndromes are more common in women then in men and are less related to the presence of atherosclerosis in the epicardial coronary arteries.<cite>8</cite> | ||
There are no gender-specific criteria for the interpretation of ECG’s. Non specific ECG changes at rest, a lower exercise capacity and a smaller vessel size contribute to the lower sensitivity and specificity of non-invasive testing in women. At younger ages, endogenous estrogen level scan induce ECG changes mimicking ischemia. | There are no gender-specific criteria for the interpretation of ECG’s. Non specific ECG changes at rest, a lower exercise capacity and a smaller vessel size contribute to the lower sensitivity and specificity of non-invasive testing in women. At younger ages, endogenous estrogen level scan induce ECG changes mimicking ischemia. | ||
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Symptom management in patients with non-obstructive cardiovascular disease is a challenge. Important to differentiate between vasospastic forms and complaints related to endothelial dysfunction. Table 2 gives an overview of current treatment options. | Symptom management in patients with non-obstructive cardiovascular disease is a challenge. Important to differentiate between vasospastic forms and complaints related to endothelial dysfunction. Table 2 gives an overview of current treatment options. | ||
Lifestyle behaviors can prevent and reduce the risk of getting heart disease and should therefore be primary focus in the GP-practice. Strategies adapt health lifestyle changes are listed below Adapted from Assessment and Management of cardiovascular risk in women ESC/ESH/2007):<cite> | Lifestyle behaviors can prevent and reduce the risk of getting heart disease and should therefore be primary focus in the GP-practice. Strategies adapt health lifestyle changes are listed below Adapted from Assessment and Management of cardiovascular risk in women ESC/ESH/2007):<cite>9</cite> | ||
====Smoking: TARGET: permanently stop smoking all forms of tobacco==== | ====Smoking: TARGET: permanently stop smoking all forms of tobacco==== | ||
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#6 pmid=12575968 | #6 pmid=12575968 | ||
#7 pmid=21159671 | #7 pmid=21159671 | ||
#8 pmid=16908490 | |||
#9 Adapted from Assessment and Management of cardiovascular risk in women ESC/ESH/2007 | |||
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</biblio> | </biblio> |
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