Ischemic heart disease (IHD) represents the leading cause of death in women. It accounts for a third of all female deaths globally . In recent years, there has been growing public awareness and increasing attention to young women with acute myocardial infarction (AMI). Young women often have worse recoveries, with higher risk for morbidity and mortality compared with similarly aged men. On presentation for AMI, young women have higher rates of traditional cardiovascular risk factors such as diabetes mellitus and obesity and are more likely to have prior cardiovascular disease, including congestive heart failure, peripheral artery disease, and stroke. Despite this, young women are significantly less likely than men to report. Social factors previously associated with adverse outcomes are also more prevalent among young women, including being unemployed and being financial stress to lower strata of society in comparison to men. On healthcare access, although fewer young women with AMI (compared with men with AMI) are uninsured, they are more likely to report financial barriers to medication and healthcare services . In young women, the most common prodromal symptom leading up to the AMI is fatigue. In addition to the month before presentation of AMI, young women have a poorer health status and worse psychosocial status than men. Specifically, women report worse physical / mental functioning, more angina, worse physical limitations, and a poorer quality of life before their AMI. Chest pain is the most common presenting complaint for AMI in young women and men; however, young women are more likely to have atypical symptoms. Disease presentation is also different between the sexes; for example, young women tend to have smaller infarcts as evidenced by lower levels of cardiac biomarkers and are less likely to have ST-segment–elevation myocardial infarction. Possible Risk Factors for CHD Among Women Factors Unique to Women

- Menarche
- Postmenopausal state
- Use of oral contraceptives
- Pregnancy complications: gestational diabetes and hypertension; preeclampsia
- Spontaneous pregnancy loss (not induced abortion)
- Preterm birth

. Smoking, Family history or stressful life events . To date, there is suboptimal recognition of the atypical presentation of MI in women. Of concern, even when the symptoms were recognized, only half would seek medical attention. Two contemporary prospective studies have, in particular, informed our recent understanding of outcomes and predictors of outcomes, among young women with AMI are the VIRGO and GENESIS-PRAXY trials. Outcomes

- Women have worse short- and long-term outcomes than men attributed to greater baseline comorbidities
- Women without chest pain at presentation have worse outcomes than men with chest pain.

Improved awareness of risk for IHD are paramount for improving outcomes in women. Public education campaigns and tailored social media messages need to include young women and minorities. Collaboration between local faith–based organizations, local gyms, schools, community leaders, and work-place wellness sites to engender heart-healthy behaviors, improved health literacy, and improved adherence to lifestyle-based primary prevention in a manner that is culturally acceptable, affordable, and readily accessible may be helpful. Dr. Devendra K Shrimal Interventional Cardiologist Director, Department of Cardiology Narayana Multispeciality Hospital Jaipur.