Over the years, many clinical trials have provided evidence that there are substantial gender differences in the pathophysiology, clinical presentation, diagnosis, and treatment of coronary artery disease (CAD). Although women have a higher atherosclerotic burden, are more symptomatic, and have a worse clinical outcome, they have a lower prevalence of obstructive coronary disease than men [
1,
2]. The pathophysiology of heart disease in women is a spectrum and, therefore, one must consider a unique evaluation approach, which in some cases will spread beyond the detection of epicardial stenosis to include evaluation of the atherosclerotic burden as well as an evaluation of coronary reactivity of the microvasculature and endothelium [
3]. …