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CAD Testing Challenges in Women

Because heart diseases like coronary artery disease (CAD) can be life threatening, it's important to evaluate and rule out CAD as the cause of your symptoms. Unfortunately, most common tests for CAD do not take into consideration some of the cardiovascular differences between men and women. Certain parts of our bodies, such as our smaller hearts and breast tissue, can impact the accuracy of common CAD imaging tests, leading to higher rates of false-positive test results.1

Because it is harder to diagnose CAD in women, we often undergo multiple and sometimes unnecessary repeat tests. This prolonged testing pathway can expose female patients, who are already at greater risk of side effects and complications than men, to additional tests and their associated risks. For instance, breast tissue in women can be more susceptible to damage caused by radiation, which can increase the risk of cancer.

While scans are an important tool for use in patients with a high risk of CAD, patients and healthcare providers need to be wary of performing unnecessary tests, particularly if the test uses high doses of radiation.

The radiation exposure you receive from one nuclear stress test (a common X-ray test for CAD) alone can be equivalent to 39 mammograms,2 or approximately 13.6 years3 worth of natural radiation.

Since 1980, patients in the U.S. have experienced a six-fold increase in radiation exposure from medical imaging. Nearly 40% of this exposure (excluding radiotherapy) is related to cardiovascular imaging and intervention. Because of this increase, the American Heart Association issued a scientific statement in September 2014 advising healthcare providers to discuss the diagnostic accuracy, cost, availability, convenience, and risk factors of each testing option they may suggest for their patients.

By learning your testing options and working with your healthcare provider to determine the right testing plan, you may be able to get to the cause of your symptoms faster and with less risk. Remember, you play an active role in the care you receive.

Get informed and be prepared to talk to your healthcare provider with our side-by-side comparison chart of testing methods.

† A result that indicates that a given condition is present when it is not. An example of a false-positive would be if a particular test designed to detect pregnancy returns a positive result but the woman is not actually pregnant.

  1. Kwok Y, Kim C, Grady D, et al. Meta-Analysis of Exercise Testing to Detect Coronary Artery Disease in Women. Am J Cardiol 1999;83:660-6
  2. Fazel R, Krumholz HM, Wang Y, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med. 2009;361:849-857.
  3. Food and Drug Administration. (November 2009). Radiation Emitting Products: Fluoroscopy. Accessed January 19, 2010, at http://www.fda.gov/Radiation-EmittingProducts/RadiationEmittingProductsandProcedures/MedicalImaging/MedicalX-rays/ucm115354.htm (Pulled from http://www.stopcancerfund.org/pz-environmental-exposures/everything-you-ever-wanted-to-know-about-radiation-and-cancer-but-were-afraid-to-ask-2)