[Coronary artery disease in women: True specificities to know in order to improve management and outcome].

Coronary artery disease is the leading death for women in Europe and developed countries. It kills seven times more than breast cancer. The number of deaths from coronary artery disease increase and affects also younger women (< 55 years old). Coronary artery disease in women is a major public health problem, often underestimated. Women should become a priority target of prevention. Traditional vision of coronary artery disease as myocardial ischemia due to obstruction of major coronary arteries do not represent all the aspects of ischemic disease in women. Myocardial ischemia without obstruction of major coronary arteries, described as microvascular dysfunction is often unknown and ignored. It is yet a situation at high cardiovascular risk. Presentation and symptoms of coronary artery disease are misleading in women. Coronary artery disease in women remains under-diagnosed and under-treated. It is necessary to improve management of women at cardiovascular risk, whose inequalities contribute to the excess of female mortality from coronary artery disease. Coronary artery disease in women needs new diagnostic and therapeutic approaches. It must take into account specific risk stratification, evaluation of particular chest pain and reduced performance of non-invasive testing.