Cardiovascular Anatomy and Physiology in the Female
Abstract
Important differences in male and female cardiovascular anatomy and physiology may account for many of the gender differences seen in various cardiac disease states. Predominant influences on female disease manifestations include (1) women's smaller body size, hence smaller hearts and smaller coronary vessels and (2) women's fluctuating levels of estrogen throughout their lifespan. Understanding these critical anatomic and physiologic differences allows the clinician to better predict and plan care for women. For example, knowing that women generally have a smaller body surface area than men allows one to better understand why men have higher creatine kinase (CK) values than do women--an important distinction when interpreting these values in the acute care setting. The fact that women's hearts and coronary vessels are generally smaller than men's also helps one understand why women have a higher in-hospital mortality than men post-coronary artery bypass graft surgery (see article by Allen in this issue for more detailed information on revascularization). These are only a few examples of the many opportunities that acute care nurses have to integrate their knowledge of anatomy and physiology into proactive planning for their female cardiac patients.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Males have superior cardiovascular and respiratory function compared with females, with larger blood and heart volumes, higher hemoglobin concentration, greater cross-sectional area of the trachea and lower oxygen cost of respiration.
“superior cardiovascular and respiratory function, with larger blood and heart volumes, higher hemoglobin concentration, greater cross-sectional area of the trachea and lower oxygen cost of respiration [3, 4, 39, 40].”
From Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage (2021) · cites this paper as [40]
Cites
Joannidès, R., Haefeli, W. E., Linder, L., Richard, V. J., Bakkali, E. H., Thuillez, C., & Lüscher, T. F. (1995) · Circulation · doi:10.1161/01.cir.91.5.1314 · Cited by 1,622 · see citing works
Standardization of M-mode echocardiographic left ventricular anatomic measurements
Devereux, R. B., Lutas, E. M., Casale, P. N., Kligfield, P., Eisenberg, R. R., Hammond, I. W., Miller, D. H., Reis, G. J., Alderman, M. H., & Laragh, J. H. (1984) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(84)80141-2 · Cited by 742 · see citing works
The triglyceride issue: A view from Framingham
Castelli, W. P. (1986) · American Heart Journal · doi:10.1016/0002-8703(86)90296-6 · Cited by 664 · see citing works
Hypertensive Hypertrophic Cardiomyopathy of the Elderly
Topol, E. J., Traill, T. A., & Fortuin, N. J. (1985) · New England Journal of Medicine · doi:10.1056/nejm198501313120504 · Cited by 649 · see citing works
Sex differences in the evolution of the electrocardiographic QT interval with age.
Rautaharju, P. M., Sh, Z., Wong, S., Hp, C., Berenson, G. S., Prineas, R., & Davignon, A. (1992) · PubMed · Cited by 635 · see citing works
Gender- and age-related differences in heart rate dynamics: Are women more complex than men?
Ryan, S. M., Goldberger, A. L., Pincus, S. M., Mietus, J. E., & Lipsitz, L. A. (1994) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(94)90177-5 · Cited by 454 · see citing works
Fisher, L. D., Kennedy, J. W., Davis, K. B., Maynard, C. C., Fritz, J. K., Kaiser, G. C., & Myers, W. O. (1982) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(19)39000-2 · Cited by 410 · see citing works
SIMONE, G. D., Devereux, R. B., Chien, S., Alderman, M. H., Atlas, S. A., & Laragh, J. H. (1990) · Circulation · doi:10.1161/01.cir.81.1.107 · Cited by 336 · see citing works
Rosselli, M., Imthurn, B., Keller, P. J., Jackson, E. K., & Dubey, R. K. (1995) · Hypertension · doi:10.1161/01.hyp.25.4.848 · Cited by 264 · see citing works
Hammond, I. W., Devereux, R. B., Alderman, M. H., & Laragh, J. H. (1988) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(88)90467-6 · Cited by 241 · see citing works
Effects of age, sex, and race on ECG interval measurements
Macfarlane, P. W., McLaughlin, S. C., Devine, B., & Yang, T.-F. (1994) · Journal of Electrocardiology · doi:10.1016/s0022-0736(94)80039-1 · Cited by 175 · see citing works
Sex-related differences in the normal cardiac response to upright exercise.
Higginbotham, M. B., Morris, K. G., Coleman, R. E., & Cobb, F. R. (1984) · Circulation · doi:10.1161/01.cir.70.3.357 · Cited by 155 · see citing works
Cytoprotective effects of nitric oxide.
Cooke, J. P., & Tsao, P. S. (1993) · Circulation · doi:10.1161/01.cir.88.5.2451 · Cited by 151 · see citing works
The Effects of Transdermal Estradiol and Oral Conjugated Estrogens on Haemostasis Variables
Kroon, U. ‐., Silfverstolpe, G., & Tengborn, L. (1994) · Thrombosis and Haemostasis · doi:10.1055/s-0038-1642453 · Cited by 147 · see citing works
Lauer, M. S., Anderson, K. M., & Levy, D. (1991) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(91)90549-o · Cited by 143 · see citing works
Cardiovascular Health and Disease in Women
Otto, C. M. (1994) · JAMA · doi:10.1001/jama.1994.03510390086044 · Cited by 141 · see citing works
Impairment of Endothelium-Dependent Dilation in Rabbit Renal Arteries by Oxidized Lipoprotein(a)
Galle, J., Bengen, J., Schollmeyer, P. J., & Wanner, C. (1995) · Circulation · doi:10.1161/01.cir.92.6.1582 · Cited by 133 · see citing works
Burke, J. H., Goldberger, J. J., EHLERT, F. A., Kruse, J. T., Parker, M. A., & Kadish, A. H. (1996) · The American Journal of Medicine · doi:10.1016/s0002-9343(96)00018-6 · Cited by 127 · see citing works
Heterogeneity of Serum Creatine Kinase Activity among Racial and Gender Groups of the Population
Wong, E. T., Cobb, C. J., Umehara, M. K., Wolff, G. A., Haywood, L. J., Greenberg, T., & Shaw, S. T. (1983) · American Journal of Clinical Pathology · doi:10.1093/ajcp/79.5.582 · Cited by 123 · see citing works
Roberts, C. S., & Roberts, W. C. (1980) · Circulation · doi:10.1161/01.cir.62.5.953 · Cited by 120 · see citing works
SIMONE, G. D., Devereux, R. B., Roman, M. J., Ganau, A., Chien, S., Alderman, M. H., Atlas, S. A., & Laragh, J. H. (1991) · The American Journal of Cardiology · doi:10.1016/0002-9149(91)90333-g · Cited by 112 · see citing works
Sex Differences in the Electrocardiogram
Simonson, E., BLACKBURN, H. W., Puchner, T. C., EISENBERG, P., RIBEIRO, F., & MEJA, M. (1960) · Circulation · doi:10.1161/01.cir.22.4.598 · Cited by 97 · see citing works
Exercise electrocardiogram patterns in normal women.
Cumming, G. R., Dufresne, C., Kich, L., & Samm, J. (1973) · Heart · doi:10.1136/hrt.35.10.1055 · Cited by 93 · see citing works
Incidence of Lp(a) Lipoprotein among Populations
Dahlén, G. H. (1990) · Elsevier eBooks · doi:10.1016/b978-0-12-620990-7.50014-0 · Cited by 91 · see citing works
Left ventricular function in men and women. Another difference between sexes
Buonanno, C., Arbustini, E., Rossi, L., Dander, B., Vassanelli, C., Paris, B., & Poppi, A. (1982) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a061347 · Cited by 52 · see citing works
Relation of results of exercise stress tests in young women to phases of the menstrual cycle
Clark, P. I., Glasser, S. P., Lyman, G. H., Krug-Fite, J., & Root, A. W. (1988) · The American Journal of Cardiology · doi:10.1016/0002-9149(88)91334-3 · Cited by 46 · see citing works
Epidemiologic Associations Between Hypertriglyceridemia and Coronary Heart Disease
Austin, M. A. (1988) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-2007-1002767 · Cited by 43 · see citing works
Lipoprotein(a) in PROCAM Participants and Young Myocardial Infarction Survivors
Sandkamp, M., & Assmann, G. (1990) · Elsevier eBooks · doi:10.1016/b978-0-12-620990-7.50017-6 · Cited by 40 · see citing works
Risks of estrogens and progestogens
L'Hermite, M. (1990) · Maturitas · doi:10.1016/0378-5122(90)90005-q · Cited by 39 · see citing works
Plasminogen Activators t-PA, u-PA and Its Inhibitor (PAI) in Normal Males and Females
Koh, S. C. L., Yuen, R., Viegas, O. A. C., Chua, S. E., Ng, B. L., Sen, D. K., & Ratnam, S. S. (1991) · Thrombosis and Haemostasis · doi:10.1055/s-0038-1646463 · Cited by 26 · see citing works
Cook, J. C., Wong, E. T., & Haywood, L. J. (1990) · PubMed · Cited by 10 · see citing works
Coronary Atherosclerotic Heart Disease: Some Important Differences in Men and Women
Glazer, & Hurst, J. W. (2017) · American Journal of Noninvasive Cardiology · doi:10.1159/000470731 · Cited by 10 · see citing works
Elevated arterial pressure and postexertional ST-segment depression in middle-aged women
Kusumi, F., Bruce, R. A., Ross, M. A., Trimble, S., & Voigt, A. (1976) · American Heart Journal · doi:10.1016/s0002-8703(76)80076-2 · Cited by 9 · see citing works
Heart Size Estimates Indexed Optimally to Body and Chest Size
Rautaharju, P. M., LaCroix, A. Z., Savage, D. D., Cox, C. S., Madans, J. H., Warren, J., Wolf, H. K., & Hadden, W. C. (2017) · American Journal of Noninvasive Cardiology · doi:10.1159/000470518 · Cited by 4 · see citing works
Holm, K., Penckofer, S. M., Keresztes, P. A., Biordi, D. L., & Chandler, P. J. (1993) · PubMed · Cited by 3 · see citing works
Flagged first, then by citations
1 of the 36 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Hilton, E. N., & Lundberg, T. R. (2021) · Sports Medicine · doi:10.1007/s40279-020-01389-3 · Cited by 170 · see citing works
Myocardial infarction: survivors’ and spouses’ stress, coping, and support
Stewart, M., Davidson, K. W., Meade, D., Hirth, A., & Makrides, L. (2000) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2000.01454.x · Cited by 138 · see citing works
Sex Differences in Heart Failure
Savarese, G., & D’Amario, D. (2018) · Advances in experimental medicine and biology · doi:10.1007/978-3-319-77932-4_32 · Cited by 61 · see citing works
Women’s help-seeking behaviour at the onset of myocardial infarction
Higginson, R. (2008) · British Journal of Nursing · doi:10.12968/bjon.2008.17.1.28054 · Cited by 55 · see citing works
Chung, J.-H., Lee, K. E., Lee, J. M., Her, A., Kim, C. H., Choi, K. H., Song, Y. B., Hahn, J., Kim, H. Y., Choi, J., et al. (2020) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2020.04.002 · Cited by 46 · see citing works
APPLICATION OF FEMINIST THEORY IN NURSING RESEARCH: THE CASE OF WOMEN AND CARDIOVASCULAR DISEASE
McCormick, K. M., & Bunting, S. M. (2002) · Health Care For Women International · doi:10.1080/07399330290112344 · Cited by 42 · see citing works
Mireles, J. A. G., Lares‐Asseff, I., Espinoza, E. A. R., Blanco, J. G., Font, A. E. G., Hurtado, L. P. C., Castañeda, V. L., Villanueva‐Fierro, I., Romero, L. P., & Almanza-Reyes, H. E. (2021) · Pharmacogenetics and Genomics · doi:10.1097/fpc.0000000000000428 · Cited by 25 · see citing works
Sex-Specific Impacts of Exercise on Cardiovascular Remodeling
Islam, R. A., Khalsa, S. S. S., Vyas, A. K., & Rahimian, R. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10173833 · Cited by 24 · see citing works
Cue Sensitivity in Women With Cardiac Disease
Miller, C. L. (2000) · Progress in Cardiovascular Nursing · doi:10.1111/j.1751-7117.2000.tb00210.x · Cited by 21 · see citing works
Sex differences in murine cardiac pathophysiology with hyperoxia exposure
Rodgers, J. L., Rodgers, L. E., Tian, Z., Allen‐Gipson, D., & Panguluri, S. K. (2018) · Journal of Cellular Physiology · doi:10.1002/jcp.27010 · Cited by 16 · see citing works
Dias, S., Anselmi, C., Espada, Y., & Martorell, J. (2021) · Veterinary Radiology & Ultrasound · doi:10.1111/vru.12973 · Cited by 12 · see citing works
Muzio, F. P. L., Rozzi, G., Rossi, S., Gerbolés, A. G., Fassina, L., Pelà, G. M., Luciani, G. B., & Miragoli, M. (2019) · Progress in Biophysics and Molecular Biology · doi:10.1016/j.pbiomolbio.2019.05.003 · Cited by 11 · see citing works
Valvular heart diseases in women
Youssef, G. (2021) · The Egyptian Heart Journal · doi:10.1186/s43044-021-00184-3 · Cited by 10 · see citing works
Mireles, J. A. G., Lares‐Asseff, I., Espinoza, E. A. R., Hurtado, L. P. C., Gándara, H. P., Ortiz, M. B., Loera‐Castañeda, V., Romero, L. P., & Almanza-Reyes, H. E. (2024) · Nutrition and Cancer · doi:10.1080/01635581.2024.2378502 · Cited by 8 · see citing works
Residual angina in female patients after coronary revascularization.
Vogel, B., Goel, R., Kunadian, V., Kalkman, D., Chieffo, A., Appelman, Y., & Mehran, R. (2019) · International Journal of Cardiology · doi:10.1016/j.ijcard.2019.01.043 · Cited by 8 · see citing works
Advanced Cardiac Imaging and Women’s Chest Pain: A Question of Gender
Dell’Aversana, F., Tedeschi, C., Comune, R., Gallo, L., Ferrandino, G., Basco, E., Tamburrini, S., Sica, G., Masala, S. A., Scaglione, M., et al. (2023) · Diagnostics · doi:10.3390/diagnostics13152611 · Cited by 5 · see citing works
Williams, A., Ueda, Y., Stern, J. A., & Christe, K. L. (2020) · Journal of the American Association for Laboratory Animal Science · doi:10.30802/aalas-jaalas-19-000143 · Cited by 5 · see citing works
Hilton, E. N., & Lundberg, T. R. (2020) · Preprints.org · doi:10.20944/preprints202005.0226.v1 · Cited by 4 · see citing works
Anxiety after Acute Myocardial Infarction and In-Hospital Complications
An, K. (2002) · Daehan ganho haghoeji · doi:10.4040/jkan.2002.32.7.999 · Cited by 3 · see citing works
Biomaterials for Cardiovascular Applications
Suhag, D. (2024) · Biomedical materials for multi-functional applications · doi:10.1007/978-981-97-5906-4_4 · Cited by 2 · see citing works
Interventions in Ischemic Heart Disease
Kalkman, D. N., Vogel, B., Goel, R., & Mehran, R. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-819369-3.00014-9
Li, S., Xu, Y., Zhang, S., Han, Z., & Liu, X. (2026) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2026.1726345
Mireles, J. A. G., Espinoza, E. A. R., Loera‐Castañeda, V., Hurtado, L. P. C., Font, A. E. G., Avila, J. C. G., Fierro, I. V., Lares-Asseff, I., Muñoz, C. M., Villa, G. V., et al. (2026) · Current Issues in Molecular Biology · doi:10.3390/cimb48060577
Sex Differences in the Anatomy and Physiology of the Cardiovascular System
LoMauro, A., & Aliverti, A. (2026) · Physiology in health and disease · doi:10.1007/978-3-032-26472-5_4
- Authors
- Wingate, S.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Wingate, Sue
- Venue
- Critical Care Nursing Clinics of North America
- Publisher
- Elsevier BV
- Published
- 1997-12
- Volume
- 9
- Issue
- 4
- Pages
- 447-452
- ISSN
- 0899-5885 (ISSN-L)
- OpenAlex
- W2416161115
- Cited by
- 24
- References
- 36
- Citations by year
- 2026: 3 · 2024: 2 · 2023: 1 · 2021: 5 · 2020: 4 · 2019: 2 · 2018: 2
- FWCI
- 0.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Critical Care Nursing Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Keywords
- estrogen, body size, creatine kinase, in-hospital mortality, coronary artery bypass grafting, acute cardiac care
- MeSH terms
- Cardiovascular System, Cardiovascular Physiological Phenomena, Female, Humans, Male, Sex Characteristics, Women's Health
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
