Prevalence of disease in 50+, regardless of sex, high enough whereby work-ups should proceed if pre-test prob merits. Taking into account the variable symptoms between sexes is part of that equation.
I recall one case of Takutsubo cardiac symptoms who was worked up with clear angiograms. She very clearly identified the situation which set off her symptoms.
Prinzmetal angina was popular when I was an intern, but seemed to disappear from the differential diagnosis about 20 years ago. Testing then was ECG with CKMB, now troponins give more sensitive results. Both would fit into your MINOCA group, but really they are diagnoses of exclusion and still need to be worked up.
In looking at the data from the Diamond and Forrester studies you have presented from the 1970's, it strikes me that you could get the same outcomes by using smoking rates- male smokers would have been about the same ratio to females as the cardiac outcomes. (I didn't review the original articles to see if this was noted therein.)
Prevalence of disease in 50+, regardless of sex, high enough whereby work-ups should proceed if pre-test prob merits. Taking into account the variable symptoms between sexes is part of that equation.
The cynical me wonders whether the unfortunate results of the Covid shots are not welcomed by a large percentage of cardiologists.
I recall one case of Takutsubo cardiac symptoms who was worked up with clear angiograms. She very clearly identified the situation which set off her symptoms.
Prinzmetal angina was popular when I was an intern, but seemed to disappear from the differential diagnosis about 20 years ago. Testing then was ECG with CKMB, now troponins give more sensitive results. Both would fit into your MINOCA group, but really they are diagnoses of exclusion and still need to be worked up.
In looking at the data from the Diamond and Forrester studies you have presented from the 1970's, it strikes me that you could get the same outcomes by using smoking rates- male smokers would have been about the same ratio to females as the cardiac outcomes. (I didn't review the original articles to see if this was noted therein.)