Today, women are getting pregnant using in vitro methods at ages historically not associated with reproduction. Physicians increasingly have to screen pregnant women in their forties and fifties for potential cardiac risk. Again, newer, noninvasive, nonradioactive technologies such as echocardiography come into play, allowing physicians to safely and accurately diagnose and treat these women. Physicians should also carefully identify family histories, cholesterol levels, risk for diabetes, and blood pressure levels.

In addition, physicians need to be aware of differing disease pathologies as our population ages and as female baby boomers enter the postmenopausal era in record numbers. After menopause, women face an accelerated development of arterial disease. However, women may have already built up soft plaques that conventional tools—such as CT scans for calcium—fail to detect. Coratid Doppler and CT angiograms, looking for occult atheroscherosis, offer solutions for this group.

The use of hormone replacement therapy (HRT) for postmenopausal women has been studied for a long period of time. Clearly, hormone replacement therapy has a place in the treatment of some women. However, its specific role in preventing coronary artery disease and its complications remains less clear and is a subject of active debate. Physicians should now reconsider prescribing HRT in the context of heart disease, as well as the patient's risk for clotting disorders.