Management of cardiac emergencies in women: a clinical consensus statement of the Association for Acute CardioVascular Care (ACVC), the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the Heart Failure Association (HFA), and the European Heart Rhythm Association (EHRA) of the ESC, and the ESC Working Group on Cardiovascular Pharmacotherapy

Author:

Sambola Antonia1,Halvorsen Sigrun23ORCID,Adlam David4,Hassager Christian5ORCID,Price Susanna6ORCID,Rosano Giuseppe78ORCID,Schiele Francois9ORCID,Holmvang Lene5,de Riva Marta10,Rakisheva Amina1112,Sulzgruber Patrick13ORCID,Swahn Eva14

Affiliation:

1. Department of Cardiology and Research Institute, University Hospital Vall d’Hebron, Universitat Autònoma, CIBER Cardiovascular diseases (CIBER-CV) , Barcelona , Spain

2. Department of Cardiology, Oslo University Hospital Ulleval , P.O. Box 4956 Nydalen, N-0424 Oslo , Norway

3. Institue of Clinical Medicine, University of Oslo , P.O. Box 1171 Blindern, N-0318 Oslo , Norway

4. Department of Cardiovascular Sciences, University of Leicester, NIHR Leicester Biomedical Research Centre , Leicester , UK

5. Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet , Copenhagen , Denmark

6. Adult Intensive Care Unit, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London , UK

7. Cardiovascular Clinical Academic Group, St George’s University Hospital , London , UK

8. Cardiology, San Raffaele Cassino Hospital , Cassino , Italy

9. Department of Cardiology, University Hospital Besancon , Besancon , France

10. Department of Cardiology, Leiden University Medical Center , Leiden , Netherlands

11. , City Cardiology Center Department of Cardiology , Almaty, Kazakhstan

12. Department of Cardiology, Qonaev City Hospital , Almaty Region , Kazakhstan

13. Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna , Vienna , Austria

14. Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linköping University , Linköping , Sweden

Abstract

Abstract Cardiac emergencies in women, such as acute coronary syndromes, acute heart failure, and cardiac arrest, are associated with a high risk of adverse outcomes and mortality. Although women historically have been significantly underrepresented in clinical studies of these diseases, the guideline-recommended treatment for these emergencies is generally the same for both sexes. Still, women are less likely to receive evidence-based treatment compared to men. Furthermore, specific diseases affecting predominantly or exclusively women, such as spontaneous coronary dissection, myocardial infarction with non-obstructive coronary arteries, takotsubo cardiomyopathy, and peripartum cardiomyopathy, require specialized attention in terms of both diagnosis and management. In this clinical consensus statement, we summarize current knowledge on therapeutic management of these emergencies in women. Key statements and specific quality indicators are suggested to achieve equal and specific care for both sexes. Finally, we discuss several gaps in evidence and encourage further studies designed and powered with adequate attention for sex-specific analysis.

Publisher

Oxford University Press (OUP)

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