ACS in young women: Landmark advice urges low threshold for invasive angiography

A landmark statement on managing premenopausal women with suspected acute coronary syndrome has called for a low threshold for invasive angiography in patients with significant risk factors, including pregnant women.

Led by Australia’s Professor Jason Kovacic, the American Heart Association scientific statement says it is the first attempt to develop an integrated management pathway for diagnosing and managing young women with acute coronary syndrome (ACS).

Writing in Circulation this month, the authors say a high index of suspicion is needed to diagnose ACS in premenopausal women because of its rarity in this cohort, when chest pain is a common presentation for adults.

Premenopausal women have a relatively greater incidence of both MI with non-obstructive coronary arteries (MINOCA) and spontaneous coronary artery dissection (SCAD), the statement says.

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