Signs and symptoms of suspected myocardial ischemia in women

Results from the what is the optimal method for ischemia evaluation in women? Trial

Jennifer H. Mieres, Gary V. Heller, Robert Hendel, Martha Gulati, William E. Boden, Deborah Katten, Leslee J. Shaw

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: Much of our understanding of gender differences in chest pain was derived from noncontemporary reports. The aim of the current report was to compare the frequency of chest pain by measures of ischemia in 824 women with suspected myocardial ischemia prospectively enrolled in a clinical trial of exercise testing with electrocardiography (ETT-ECG) alone compared to myocardial perfusion single photon emission computed tomography (SPECT) (ETT-MPS). Methods: Women seeking evaluation of chest pain or anginal equivalent symptoms were randomized to ETT-ECG or ETT-MPS with Tc-99m tetrofosmin. The Women's Ischemia Syndrome Evaluation (WISE) and Seattle Angina Questionnaire (SAQ) chest pain and Duke Activity Status Index (DASI) questionnaires were employed in enrolled women. Higher SAQ scores denote improved symptoms or functioning. Results: Eight hundred twenty-four women, average age 63 years, at intermediate-high coronary artery disease (CAD) likelihood were enrolled from 43 North American centers. Traditional cardiac risk factors were prevalent, with nearly half of women having a family history of premature coronary disease, hypertension, and hyperlipidemia. Chest pain symptoms occurring at least one to three times per week were reported in 60% of women. An examination of the SAQ domains revealed that although women reported minimal physical limitations (median, interquartile range [IQR] 88, 75-100), there was a greater frequency of stable chest pain symptoms (median, IQR=40, 30-50). The majority of women (79%) reported moderate to heavy physical activity levels at home, with the average ETT and DASI estimated metabolic equivalents (METs) of 8.6±2.6 and 11.5±3.8. Women with more frequent daily episodes of chest pain were more likely to have a lower Duke Treadmill Score (DTS), 1 or mm of ST segment depression, and an abnormal MPS. Conclusions: The current report details a contemporary evaluation of female-specific symptomatology and measures of myocardial ischemia. Women reporting frequent angina were more likely to exhibit ischemia and this may characterize a female-specific typical angina pattern.

Original languageEnglish
Pages (from-to)1261-1268
Number of pages8
JournalJournal of Women's Health
Volume20
Issue number9
DOIs
StatePublished - Sep 1 2011

Fingerprint

Signs and Symptoms
Myocardial Ischemia
Ischemia
Chest Pain
Exercise
Electrocardiography
Metabolic Equivalent
Hyperlipidemias
Single-Photon Emission-Computed Tomography
Coronary Disease
Coronary Artery Disease
Perfusion
Clinical Trials
Hypertension
Surveys and Questionnaires

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Signs and symptoms of suspected myocardial ischemia in women : Results from the what is the optimal method for ischemia evaluation in women? Trial. / Mieres, Jennifer H.; Heller, Gary V.; Hendel, Robert; Gulati, Martha; Boden, William E.; Katten, Deborah; Shaw, Leslee J.

In: Journal of Women's Health, Vol. 20, No. 9, 01.09.2011, p. 1261-1268.

Research output: Contribution to journalArticle

Mieres, Jennifer H. ; Heller, Gary V. ; Hendel, Robert ; Gulati, Martha ; Boden, William E. ; Katten, Deborah ; Shaw, Leslee J. / Signs and symptoms of suspected myocardial ischemia in women : Results from the what is the optimal method for ischemia evaluation in women? Trial. In: Journal of Women's Health. 2011 ; Vol. 20, No. 9. pp. 1261-1268.
@article{9eef78c5509f45b28c7b941ff284218c,
title = "Signs and symptoms of suspected myocardial ischemia in women: Results from the what is the optimal method for ischemia evaluation in women? Trial",
abstract = "Background: Much of our understanding of gender differences in chest pain was derived from noncontemporary reports. The aim of the current report was to compare the frequency of chest pain by measures of ischemia in 824 women with suspected myocardial ischemia prospectively enrolled in a clinical trial of exercise testing with electrocardiography (ETT-ECG) alone compared to myocardial perfusion single photon emission computed tomography (SPECT) (ETT-MPS). Methods: Women seeking evaluation of chest pain or anginal equivalent symptoms were randomized to ETT-ECG or ETT-MPS with Tc-99m tetrofosmin. The Women's Ischemia Syndrome Evaluation (WISE) and Seattle Angina Questionnaire (SAQ) chest pain and Duke Activity Status Index (DASI) questionnaires were employed in enrolled women. Higher SAQ scores denote improved symptoms or functioning. Results: Eight hundred twenty-four women, average age 63 years, at intermediate-high coronary artery disease (CAD) likelihood were enrolled from 43 North American centers. Traditional cardiac risk factors were prevalent, with nearly half of women having a family history of premature coronary disease, hypertension, and hyperlipidemia. Chest pain symptoms occurring at least one to three times per week were reported in 60{\%} of women. An examination of the SAQ domains revealed that although women reported minimal physical limitations (median, interquartile range [IQR] 88, 75-100), there was a greater frequency of stable chest pain symptoms (median, IQR=40, 30-50). The majority of women (79{\%}) reported moderate to heavy physical activity levels at home, with the average ETT and DASI estimated metabolic equivalents (METs) of 8.6±2.6 and 11.5±3.8. Women with more frequent daily episodes of chest pain were more likely to have a lower Duke Treadmill Score (DTS), 1 or mm of ST segment depression, and an abnormal MPS. Conclusions: The current report details a contemporary evaluation of female-specific symptomatology and measures of myocardial ischemia. Women reporting frequent angina were more likely to exhibit ischemia and this may characterize a female-specific typical angina pattern.",
author = "Mieres, {Jennifer H.} and Heller, {Gary V.} and Robert Hendel and Martha Gulati and Boden, {William E.} and Deborah Katten and Shaw, {Leslee J.}",
year = "2011",
month = "9",
day = "1",
doi = "10.1089/jwh.2010.2595",
language = "English",
volume = "20",
pages = "1261--1268",
journal = "Journal of Women's Health",
issn = "1540-9996",
publisher = "Mary Ann Liebert Inc.",
number = "9",

}

TY - JOUR

T1 - Signs and symptoms of suspected myocardial ischemia in women

T2 - Results from the what is the optimal method for ischemia evaluation in women? Trial

AU - Mieres, Jennifer H.

AU - Heller, Gary V.

AU - Hendel, Robert

AU - Gulati, Martha

AU - Boden, William E.

AU - Katten, Deborah

AU - Shaw, Leslee J.

PY - 2011/9/1

Y1 - 2011/9/1

N2 - Background: Much of our understanding of gender differences in chest pain was derived from noncontemporary reports. The aim of the current report was to compare the frequency of chest pain by measures of ischemia in 824 women with suspected myocardial ischemia prospectively enrolled in a clinical trial of exercise testing with electrocardiography (ETT-ECG) alone compared to myocardial perfusion single photon emission computed tomography (SPECT) (ETT-MPS). Methods: Women seeking evaluation of chest pain or anginal equivalent symptoms were randomized to ETT-ECG or ETT-MPS with Tc-99m tetrofosmin. The Women's Ischemia Syndrome Evaluation (WISE) and Seattle Angina Questionnaire (SAQ) chest pain and Duke Activity Status Index (DASI) questionnaires were employed in enrolled women. Higher SAQ scores denote improved symptoms or functioning. Results: Eight hundred twenty-four women, average age 63 years, at intermediate-high coronary artery disease (CAD) likelihood were enrolled from 43 North American centers. Traditional cardiac risk factors were prevalent, with nearly half of women having a family history of premature coronary disease, hypertension, and hyperlipidemia. Chest pain symptoms occurring at least one to three times per week were reported in 60% of women. An examination of the SAQ domains revealed that although women reported minimal physical limitations (median, interquartile range [IQR] 88, 75-100), there was a greater frequency of stable chest pain symptoms (median, IQR=40, 30-50). The majority of women (79%) reported moderate to heavy physical activity levels at home, with the average ETT and DASI estimated metabolic equivalents (METs) of 8.6±2.6 and 11.5±3.8. Women with more frequent daily episodes of chest pain were more likely to have a lower Duke Treadmill Score (DTS), 1 or mm of ST segment depression, and an abnormal MPS. Conclusions: The current report details a contemporary evaluation of female-specific symptomatology and measures of myocardial ischemia. Women reporting frequent angina were more likely to exhibit ischemia and this may characterize a female-specific typical angina pattern.

AB - Background: Much of our understanding of gender differences in chest pain was derived from noncontemporary reports. The aim of the current report was to compare the frequency of chest pain by measures of ischemia in 824 women with suspected myocardial ischemia prospectively enrolled in a clinical trial of exercise testing with electrocardiography (ETT-ECG) alone compared to myocardial perfusion single photon emission computed tomography (SPECT) (ETT-MPS). Methods: Women seeking evaluation of chest pain or anginal equivalent symptoms were randomized to ETT-ECG or ETT-MPS with Tc-99m tetrofosmin. The Women's Ischemia Syndrome Evaluation (WISE) and Seattle Angina Questionnaire (SAQ) chest pain and Duke Activity Status Index (DASI) questionnaires were employed in enrolled women. Higher SAQ scores denote improved symptoms or functioning. Results: Eight hundred twenty-four women, average age 63 years, at intermediate-high coronary artery disease (CAD) likelihood were enrolled from 43 North American centers. Traditional cardiac risk factors were prevalent, with nearly half of women having a family history of premature coronary disease, hypertension, and hyperlipidemia. Chest pain symptoms occurring at least one to three times per week were reported in 60% of women. An examination of the SAQ domains revealed that although women reported minimal physical limitations (median, interquartile range [IQR] 88, 75-100), there was a greater frequency of stable chest pain symptoms (median, IQR=40, 30-50). The majority of women (79%) reported moderate to heavy physical activity levels at home, with the average ETT and DASI estimated metabolic equivalents (METs) of 8.6±2.6 and 11.5±3.8. Women with more frequent daily episodes of chest pain were more likely to have a lower Duke Treadmill Score (DTS), 1 or mm of ST segment depression, and an abnormal MPS. Conclusions: The current report details a contemporary evaluation of female-specific symptomatology and measures of myocardial ischemia. Women reporting frequent angina were more likely to exhibit ischemia and this may characterize a female-specific typical angina pattern.

UR - http://www.scopus.com/inward/record.url?scp=80053958828&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053958828&partnerID=8YFLogxK

U2 - 10.1089/jwh.2010.2595

DO - 10.1089/jwh.2010.2595

M3 - Article

VL - 20

SP - 1261

EP - 1268

JO - Journal of Women's Health

JF - Journal of Women's Health

SN - 1540-9996

IS - 9

ER -