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Role of Echocardiography in Evaluation of Women with Chest Pain

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Chest Pain with Normal Coronary Arteries

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Abstract

This chapter reviews the role of echocardiography in evaluation of women with chest pain. Stress echocardiography is a well-established and diagnostically reliable modality for assessment of women with chest pain and suspected myocardial ischemia due to epicardial coronary artery disease. The technique is particularly suitable in women because of the lack of radiation and applicability in individuals who are or are not able to exercise. The chapter addresses the difficult issue of chest pain in women with angiographically normal coronary arteries, including prognostic role of stress echocardiography in these women, and newer echocardiographic techniques for assessment of coronary flow reserve and detection of microvascular disease. The importance of coronary flow reserve abnormalities in women with chest pain is examined.

The chapter concludes with a discussion of the role of transthoracic echocardiography in assessment of two other important cardiac causes of chest pain in women with angiographically normal coronary arteries – hypertrophic cardiomyopathy and stress-induced cardiomyopathy. The typical echocardiographic features of both types of cardiomyopathies are reviewed. Also, the role of coronary flow reserve and myocardial contrast in clarifying the causes of ischemia in these entities is examined.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, George Washington University Medical Center, 2150 Pennsylvania Avenue NW, Suite 4-414, Washington, DC, 20037, USA

    Jannet F. Lewis MD

  2. Division of Cardiology, Department of Medicine, George Washington University Medical Center, 2150 Pennsylvania Ave., Suite 4-417, Washington, DC, 20037, USA

    Brian G. Choi MD, MBA

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Correspondence to Jannet F. Lewis MD .

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Editors and Affiliations

  1. Medical School, Coronary Artery Disease, Research Group, St George's Hospital, Cranmer Terrace, London, SW17 0RE, United Kingdom

    Juan Carlos Kaski

  2. University of Sydney, Discipline of Surgery, The Whiteley-Martin Research Centre, Parker Street, Sydney, 2747, New South Wales, Australia

    Guy D. Eslick

  3. , Women's Heart Center, Cedars-Sinai Heart Institute, S. San Vicente Blvd 444, Los Angeles, 90048, USA

    C. Noel Bairey Merz

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Lewis, J.F., Choi, B.G. (2013). Role of Echocardiography in Evaluation of Women with Chest Pain. In: Kaski, J., Eslick, G., Bairey Merz, C. (eds) Chest Pain with Normal Coronary Arteries. Springer, London. https://doi.org/10.1007/978-1-4471-4838-8_22

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