Infarction of the heart

The symptomatology of the acute attack and related data will be related to cardiac infarction in the second part of this study.

Abstract

The mechanisms behind gender differences in the experience of cardiovascular diseases remain obscure. Women are less affected by ischemic heart disease until menopause, after which the incidence of and mortality from heart disease accelerates. A collective body of work accumulated in the last several decades demonstrates that estrogen protects the heart from various forms of insults, including ischemic, cytotoxic, and hypertrophic stressors. Estrogen regulates cardiac metabolism, effects cytoprotection, promotes cardiomyocyte regeneration, regulates effective left ventricular remodeling, and stabilizes the electrophysiological and contractile function of the heart. The underlying mechanisms involve a complex network of molecular pathways mediated by estrogen signaling in the heart. The molecular, cellular, and physiological evidence for estrogen's actions on cardiomyocytes—the cells making up the largest part of the heart by mass and chiefly responsible for cardiac contraction and conduction—is discussed in this chapter with the overall goal of better appreciating biological explanations for gender differences in the cardiovascular system.