Coronary heart disease presents clinically as angina pectoris, myocardial infarction, cardiac failure, arrhythmias or sudden death. The menopause adversely affects coronary artery disease progression because of the negative influence of oestrogen deficiency on the risk factors involved. The effects of the menopause on the risk factors for coronary heart disease such as insulin resistance, serum lipids, blood pressure, haemostasis and body fat distribution will be examined. Presentation and management of chest pain in women are discussed. Gender differences, incidence, clinical course and management of arrhythmias are reviewed.
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