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diagnosed of myocardial infarction, or when they are diagnosed, sometimes it is too late and may
not benefit from revascularization [Task Force for Diagnosis and Treatment of Non-ST-Segment
Elevation Acute Coronary Syndromes of European Society of Cardiology, Bassand JP, Hamm
CW, Ardissino D, Boersma E, Budaj A, Fernandez-Aviles F, Fox KA, Hasdai D, Ohman EM,
Wallentin L, Wijns W. Guidelines for the diagnosis and treatment of non-ST-segment elevation
acute coronary syndromes. Eur Heart J 2007;. The most frequent acute symptoms were shortness of breath
(57.9%), weakness (54.8%), and fatigue (42.9%). Acute chest pain was absent in 43%. Women had more acute
(mean, 7.3_4.8; range, 0 to 29) than prodromal (mean, 5.71_4.36; range, 0 to 25) symptomsThe NIH study,
titled "Women's Early Warning Symptoms of AMI," is one of the first to investigate women's
experience with heart attacks, and how this experience differs from men's.
Women with ACS are approached in a much less aggressively invasive way and receive less
interventional treatment than men even after adjusting for differences in comorbidity and number
of significant stenoses.
I
C. NOEL BAIREY MERZ, MD*
Division of Cardiology, Department of
Medicine, Cedars-Sinai Research Institute,
Cedars-Sinai Medical Center, Los Angeles,
CA; Professor of Medicine, University of
California, Los Angeles
LESLEE J. SHAW, PhD
Professor of Medicine, Division of
Cardiology, Department of Medicine,
Emory University, Atlanta, GA
*Dr. Bairey Merz has indicated serving as a consultant for the American
College of Cardiology Foundation, AusAm, Bayer, CardioVasc Clin Trials,
Dunn Group, Kieris Solutions, Ideon-Fujisawa, Pfizer, Merck, KOS, LABiomed,
National Institutes of Health (NIH Study Section), CV Therapeutics, Rodale
Press, Sanofi-Aventis, University of Pittsburgh, and VHA; lecturing for the
American Heart Association, Charlotte Carolinas Healthcare System, Mayo
Clinic, Institute for Medical Education of the American College of
Cardiology, Rush University, Merck, National Youth Leadership Forum,
Gacheon Medical School (Korea), Spanish Cardiac Society, Nuclear
Cardiology, and Wake Forest University; and owning stock in Boston
Scientific, Eli Lilly, Johnson and Johnson, and Medtronic corporations.
CREDIT
CME
586 CLEVELAND CLINIC JOURNAL OF MEDICINE VOLUME 74 • NUMBER 8 AUGUST 2007