Imaging of Heart Disease in Women

A discussion of gender-specific challenges for non-invasive detection of heart disease in women.

Course ID: Q00528 Category:
Modalities: , , , , ,


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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after March 18, 2024:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Cardiac-Interventional Radiography: 4.00
Procedures: 4.00
Diagnostic and Electrophysiology Procedures: 4.00

Computed Tomography: 3.00
Procedures: 3.00
Neck and Chest: 3.00

Nuclear Medicine Technology: 3.00
Procedures: 3.00
Cardiac Procedures: 3.00

Registered Radiologist Assistant: 4.00
Procedures: 4.00
Thoracic Section: 4.00


  1. Introduction
  2. Challenges of Noninvasive Detection of Heart Disease in Women
    1. Sex-based Differences in Anatomy and Physiology
    2. Radiation Exposure
    3. Pregnancy
    4. Sex-based Differences in Presentation and Pathogenesis of IHD
  3. Noninvasive Detection of IHD in Women
    1. Exercise ECG
    2. Stress Imaging
    3. Cardiac MR Imaging
    4. Coronary CT Angiography
  4. Nonischemic Cardiomyopathy
    1. Stress-induced Cardiomyopathy
    2. Sarcoidosis
    3. Chronic Inflammatory Diseases
  5. Heart Diseases in Pregnancy
    1. Normal Hemodynamic Alterations during Pregnancy
    2. Peripartum Cardiomyopathy
  6. Conclusion


Upon completion of this course, students will:

  1. describe the percentage of patients with stress-induced cardiomyopathy who are women
  2. list the diseases whose combined female deaths in 2010 equaled that of cardiovascular disease
  3. list the differences in heart disease prevalence and prognosis between women and men
  4. describe the anatomic differences between men and women that would affect the diagnostic performance of ECG and cardiac imaging in women
  5. identify the female hormone that can cause false-positive exercise ECG changes in women
  6. describe the prevalence of obesity among adult women from 2010 to 2014
  7. list the CT image artifacts that can be caused by obesity
  8. identify the organization that issued new recommendations in 2007 regarding the tissue weighting factor for breast tissue
  9. list the organs that have a tissue weighting factor of 0.12
  10. list the imaging modalities considered to be first-line cardiac examinations during pregnancy
  11. describe the stochastic effects that may be caused by ionizing radiation
  12. identify the radiation dose model that applies to stochastic effects from ionizing radiation
  13. describe the dose of radiation that doubles the relative risk of childhood carcinogenesis from 0.1% to 0.2%
  14. describe the radiation dose threshold that is traditionally used when considering deterministic effects of ionizing radiation exposure
  15. identify the cardiac imaging modality that results in the highest fetal radiation exposure
  16. describe the trimester of pregnancy during which the ACR considers MR imaging safe
  17. list the recommendations for decreasing fetal specific absorption rate during MR imaging
  18. identify the FDA category of agents in which intravenous iodinated contrast agents are listed
  19. describe clinically significant CAD as defined by the American College of Cardiology
  20. describe the age difference between women and men and their presentation with IHD
  21. list the cardiac risk factors included in the term metabolic syndrome
  22. list the causes of hormonal alterations that may potentiate or amplify coronary microvascular disease in women
  23. apply the interaction of MBF and CFR to the evaluation of coronary blood flow
  24. identify the noninvasive test that has the lowest sensitivity for CAD in women
  25. identify the noninvasive test that has the highest specificity for CAD in women
  26. list the quantifiable physiologic parameters that are surrogate markers of microvascular function
  27. describe the diagnostic criteria for IHD at exercise ECG
  28. identify the noninvasive test that is valuable for ruling out obstructive CAD and predicting event-free survival
  29. identify the initial noninvasive test recommended by the AHA for women with adequate exercise capacity and a normal resting ECG
  30. list the diagnostic tools above which stress imaging provides incremental value
  31. list the diagnostic tests that should be considered for symptomatic women at intermediate to high risk for CAD with poor exercise capacity
  32. describe the imaging findings that form the cornerstone of diagnosis with SPECT and PET radionuclide MPI
  33. list the reasons why 99mTc radiopharmaceuticals are preferred over 201Tl for SPECT MPI
  34. list the superior characteristics of PET MPI when compared to SPECT MPI
  35. describe the mathematical process for quantification of CFR
  36. list the imaging modalities with a class I recommendation from the American Heart Association
  37. list the imaging modalities that offer the ability to quantify MBF
  38. describe the annual mortality rate among patients with normal CT angiography results
  39. describe the techniques with the potential to improve the diagnostic accuracy of coronary CT angiography
  40. describe the diagnostic criteria for stress-induced cardiomyopathy proposed by the Mayo Clinic
  41. describe the percentage of patients with sarcoidosis that demonstrates cardiac involvement at autopsy
  42. identify the test of choice for diagnostic evaluation of sarcoidosis
  43. identify the radionuclide imaging procedure with the highest sensitivity for detecting active myocardial inflammation in sarcoidosis
  44. list the traditional risk factors for CAD that may be seen in patients with SLE or rheumatoid arthritis
  45. describe the anatomic location for the more common granulomatous form of myocarditis in rheumatoid arthritis
  46. describe the prevalence of cardiovascular disease during pregnancy in the United States
  47. describe the increase in cardiac output seen during pregnancy
  48. list the cardiac valves that may exhibit transient and mild regurgitation during pregnancy
  49. list the factors that may predict a poor prognosis for women with peripartum cardiomyopathy
  50. identify the laboratory blood tests that are recommended for the assessment of peripartum cardiomyopathy