A Study of Myocardial Infarction in Women

Coronary artery disease has been frequently viewed as a disease only of men. Carefully designed clinical trials in women with coronary artery disease have begun only since 1980. Now coronary artery disease has begun to be recognized as a leading cause of death in women. Risk factor of the disease and medical interventions have been studied thoroughly only in men. In women, use of oral contraceptive pills, hormone replacement therapy, menopause, cultural and social roles, family pressure seem to act synergistically with the known coronary artery disease risk factors and also contribute to the sex differences of the disease. Age at presentation, less specific or subtle clinical manifestations, hence not reaching the tertiary care centre at the appropriate time, greater difficulties and bias in the clinical diagnosis, higher risks involved in angiography, angioplasty and coronary artery bypass graft techniques, higher incidence of cardiac morbidity and mortality are the major sex differences studied and analyzed. Once coronary artery disease develops women have no survival advantage over men, whatever be the age group. Ventricular septal rupture, free wall rupture, congestive cardiac failure, recurrent myocardial infarction, bleeding with thrombolytic therapy is some of the common problems faced in women. Late reference, smaller body size, fragile coronary blood vessels are some of the reasons attributed to high mortality and morbidity. In the present study conducted at CMC hospital from 1st Jan to 31st Dec 2005 it was found out that the Myocardial Infarction was higher in Postmenopausal women than Premenopausal women. The multiplicity of risk factors was higher in the Premenopausal women. Typical risk factors for male Myocardial Infarction like Hypertension, Diabetes Mellitus, Obesity, Hypercholesterolemia, Positive family history also prevailed in the females. Complication and mortality were on the higher side in the case of females. Hence, coronary artery disease needs to be addressed as a special and specific issue in women. There is great scope for further studies regarding therapeutic interventions in women