Cardiology for gynecologists--a minireview.

Despite cardiovascular disease (CVD) being by far the most common cause of death in women worldwide, awareness is low. Myocardial infarction occurs 10 years later in women than in men. Symptoms may be atypical: dyspnea rather than chest pain. Also more women than men have myocardial infarction with normal coronary angiography, probably due to microvascular disease or coronary spasm. The prognosis of non-obstructive disease is now recognized to be the same than for obstructive disease. The conventional risk factors for CVD are the same for both genders but have a different impact for women. One example is psychosocial stress and angina pectoris can more often be induced by mental stress in women than in men. Also there are risk factors specific to women such as a history of pre-eclampsia, gestational hypertension or diabetes and polycystic ovary syndrome (PCOS). Furthermore atrial fibrillation increases the risk of stroke more in women than in men. However, 6 out of 10 deaths from CVD can be prevented by a healthy life style and dealing with preexisting risk factors. Hence it is important that gynecologists who start seeing women at an earlier age than cardiologists should be aware of cardiovascular disease.