Making heart disease detection a top priority among ob/gyns

In an effort to make ob/gyns more aware of the need to identify women at high risk for coronary artery disease (CAD), experts at ACOG's annual meeting in San Francisco took pains to explain the differences and similarities between men and women with the disease. Angina usually presents with the classic chest pressure and pain in the arm, neck, or jaw in both sexes. And like men, female angina sufferers typically experience these problems upon exertion and get relief when they rest. But myocardial infarctions often manifest themselves differently in women, according to Alice K. Jacobs, MD, president of the American Heart Association and director of the cardiac catheterization lab at Boston University School of Medicine. They're less likely to experience sweating and nausea and more likely to complain of fatigue.

Stress tests pose another diagnostic challenge for ob/gyns who suspect their patients are in trouble. Many older women can't reach the heart rate needed for clinicians to properly interpret the test. And the female breast can sometimes distort the results of imaging studies.

ACOG has joined forces with AHA in their "Go Red for Women" campaign, which is attempting to make the public and the profession more sensitive to the need to assess women's CAD risk factors early on. Both organizations are also steering clinicians to the new guidelines for prevention of CAD in women. (See Circulation, 2004;109:672-693 for details.)