Medical Student Case (50 page PDF. 300 Kb)
Materials to support a two session problem based learning exercise for medical students about the topic of women and heart disease, incorporating risk assessment, lifestyle counseling, and aspects of diagnosis and treatment of heart disease. Alternative endings allow exploration of medical errors (failure to diagnose heart disease in a female patient with atypical symptoms). Includes supplemental materials (ECG and dietary counseling materials available below.)

Nursing Student Case (73 page PDF, 460 Kb)
Materials to support a two session problem based learning session about women and heart disease, incorporating risk assessment, lifestyle counseling, and aspects of diagnosis and treatment of heart disease. Alternative endings allow exploration of medical errors (failure to diagnose heart disease in a female patient with atypical symptoms). Includes examination questions, references and resources. Uses supplemental materials (ECG and dietary counseling materials) available below.

Mrs. Montoya: ECG and Dietary Recommendations (7 page PDF, 1.1 Mb)
For use with problem-based learning cases above.

1. To recognize gender differences in the epidemiology, diagnosis, and treatment of heart disease.
2. To recognize that heart disease is the leading cause of death in American women of all ethnicities.
3. To respond to medical errors in the clinical setting.

Educational materials in the problem based learning case include:

• Introduction to the case
• Facilitator's guide
• Student materials
• Assessment tools
• References and resources

Update: The Heart Truth Professional Educational Program Interactive Case-based Modules

The National Heart, Lung, and Blood Institute and the American Heart Association published updated evidence-based guidelines for cardiovascular disease prevention in women electronically in the February 19, 2007, issue of Circulation.  This is available online at http://circ.ahajournals.org. Reference: Mosca L, Banka CL, Benjamin EJ et al.  Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. Circulation 2007; 115:1481.

The updates to the case-based modules are:

• Heart disease is the leading cause of death among women of all races and ethnicities, except Asian American women, where it is the second leading cause of death, after cancer.

• Folic acid, with or without vitamin B6 and B12 supplementation, should not be used for primary or secondary prevention of heart disease.  Folic acid supplementation of 400 micrograms daily remains recommended for reproductive aged women who may become pregnant, to prevent neural tube defects.

• Aspirin therapy of 75-325 mg daily is recommended in high risk women.

• Based on the best available current evidence, hormone therapy and selective estrogen-receptor modulators (SERMS) should not be used for primary or secondary prevention of cardiovascular disease.  The role of estrogen in heart disease, particularly among women in early postmenopause, is still being studied.