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Open research questions in Cardiovascular Issues in Pregnancy

90 unresolved questions extracted from the limitations and future-work sections of 255 Cardiovascular Issues in Pregnancy papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • The limitations of diagnostic paradigms historically developed in predominantly male populations. The lack of a mechanism-based approach to ischemic heart disease in women. The need for a framework that integrates determinants with contemporary coronary phenotyping.

    Beyond Coronary Stenosis: A Mechanism-Based Approach to Ischemic Heart Disease in Women · 2026 · DOI

  • One challenge is the under-recognition of coronary heart disease in young women due to dispersed early risk signals and non-cardiac symptoms. Another challenge is the lack of recognition of female-specific risk factors, such as hypertensive disorders of pregnancy and polycystic ovary syndrome. The paper also highlights the challenge of diagnostic delay and under-recognition of the disease in younger women, particularly when presentations are non-classic or non-obstructive.

    Coronary heart disease in young women: risk factors, mechanistic phenotypes, and implications for primary care · 2026 · DOI

  • The gap in the literature is the lack of recognition of coronary heart disease in young women due to dispersed early risk signals and non-cardiac symptoms. The prevailing recognition frameworks have been shaped largely by male, older, and obstructive disease patterns, leading to under-recognition of the disease in young women.

    Coronary heart disease in young women: risk factors, mechanistic phenotypes, and implications for primary care · 2026 · DOI

  • Insufficient awareness among healthcare providers, - Varying definitions of the disease across countries, - Limited availability, affordability, and expertise in Africa, - Suboptimal treatment of patients, - Relatively unfavorable outcomes

    Peripartum cardiomyopathy: a review of prevalence and treatment trends from an African perspective · 2025 · DOI

  • Research into alternative effective therapies, - Studies on the use of bromocriptine in patients with PPCM, - Investigation of the prolactin-oxidative stress mechanism

    Peripartum cardiomyopathy: a review of prevalence and treatment trends from an African perspective · 2025 · DOI

  • warfarin's safety profile is inadequately characterized due to limited high-quality evidence, - interspecies differences in warfarin teratogenicity limit the availability of high-quality evidence, - ethical considerations regarding maternal-fetal safety have limited the availability of high-quality evidence, - there is a lack of specialized guidelines and large-scale clinical studies to inform decision-making

    Mechanical tricuspid valve thrombosis in pregnancy: a case report and literature review on anticoagulation challenges and fetal protection strategies · 2025 · DOI

  • comprehensive evaluations are needed to integrate NYHA class and PAH severity based on the patient's medical history, - large-scale clinical studies are needed to inform decision-making for pregnant patients with mechanical heart valves, - research on warfarin's safety profile during pregnancy is needed

    Mechanical tricuspid valve thrombosis in pregnancy: a case report and literature review on anticoagulation challenges and fetal protection strategies · 2025 · DOI

  • There are few reports on therapeutic interventions for SCAD in the acute phase none on those performed during the subacute phase.

    Successful management of subacute stent mal-apposition confirmed using optical coherence tomography following cardiac arrest due to spontaneous coronary artery dissection in a middle-aged woman: a case report · 2026 · DOI

  • Due to limited clinical experience, there are currently no standardized management guidelines.

    Clinical features of pregnancy-associated aortic dissection and pregnancy outcomes · 2026 · DOI

  • Premenopausal women presenting with acute coronary syndrome (ACS) are a unique and often underrecognized patient population.

    Acute Coronary Syndromes in Premenopausal Women: A Scientific Statement From the American Heart Association · 2026 · DOI

  • BACKGROUND: Limited data are available regarding the relative rates, etiology, and long-term prognostic implications of spontaneous myocardial infarction (MI) after percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery for left main coronary artery disease (LMCAD).

    Spontaneous Myocardial Infarction After Left Main Revascularization: The EXCEL Trial · 2026 · DOI

  • Background Spontaneous coronary artery dissection (SCAD) predominantly affects women with limited data in men.

    Spontaneous Coronary Artery Dissection: Sex Differences in Clinical Presentation and Outcomes From the Australian New Zealand Registry · 2026 · DOI

  • Conclusion IVUS clarified lesion morphology and extent not fully defined by angiography, illustrating the complementary roles of angiographic and vessel wall information in case-specific risk assessment.

    Case Report: Spontaneous coronary artery dissection with intramural hematoma involving the LCX and the left main segment between the bifurcation and the ostium · 2026 · DOI

  • The initiating event and direction of hematoma spread could not be determined from the available imaging.

    Case Report: Spontaneous coronary artery dissection with intramural hematoma involving the LCX and the left main segment between the bifurcation and the ostium · 2026 · DOI

  • Further research is needed to assess the efficacy of CR programs in women, including women from underrepresented racial or ethnic groups, and to identify optimal CR approaches in specific populations, such as people with spontaneous coronary artery dissection, ischemia, myocardial infarction with nonobstructive coronary arteries, or stress-induced cardiomyopathy.

    Cardiac Rehabilitation in Women: A Scientific Statement From the American Heart Association · 2025 · DOI

  • Indeed, given the evolution in the global risk factor profile, the increasing importance of previously underappreciated mechanisms, the evolving appreciation of sex-specific disease characteristics, and the advent of rapidly evolving technologies, a precision medicine approach is warranted.

    Acute coronary syndromes: mechanisms, challenges, and new opportunities · 2025 · DOI

  • However, the role of GSDMD, particularly the cleaved N-terminal (NT)-GSDMD, in non-immune cells remains elusive.

    Learning from epidemiology: atrial fibrillation, peripheral artery disease, and twin pregnancy · 2025 · DOI

  • 2–9 In a Meta-Analysis article entitled ‘Major clinical outcomes in symptomatic vs asymptomatic atrial fibrillation: a meta-analysis’, Paschalis Karakasis from the Aristotle University of Thessaloniki in Greece, and colleagues note that because recent investigations have provided conflicting results, the present study aimed to evaluate the association between symptom status and clinical outcomes in patients with AF.

    Learning from epidemiology: atrial fibrillation, peripheral artery disease, and twin pregnancy · 2025 · DOI

  • Future research should examine the impact of specific measures of neighborhood deprivation on the racial and ethnic disparity in outcomes such as PPCM.

    Neighborhood Disinvestment and Racial and Ethnic Disparities in Peripartum Cardiomyopathy in California, From 2004 to 2019 · 2025 · DOI

  • INTRODUCTION: The prevalence of cardiovascular disease during pregnancy (cardiovascular disease diagnosed before, during or up to 6 months after childbirth) and the risk of adverse outcomes associated with it have not been previously described in Sweden.

    Cardiovascular disease in pregnancy: Prevalence and obstetric outcomes in a Swedish population‐based cohort study between 2000 and 2019 · 2024 · DOI

  • However, clinical evidence is currently lacking, and reliable and effective indicators for predicting the onset of PPCM are insufficient.

    The triglyceride-to-high-density lipoprotein cholesterol ratio is associated with an increased risk of peripartum cardiomyopathy · 2024 · DOI

  • Currently, the diagnosis of PPCM is not fully understood and is likely multifactorial.

    The triglyceride-to-high-density lipoprotein cholesterol ratio is associated with an increased risk of peripartum cardiomyopathy · 2024 · DOI

  • Spontaneous coronary artery dissection (SCAD), an uncommon cause of acute coronary syndrome, continues to be a poorly understood disease predominantly affecting females.

    Spontaneous coronary artery dissection and fibromuscular dysplasia: insights into recent developments · 2024 · DOI

  • Limited research in this field brings disadvantages to the understanding of the association between these two diseases, in order to give rise to better management recommendations.

    Spontaneous coronary artery dissection and fibromuscular dysplasia: insights into recent developments · 2024 · DOI

  • BACKGROUND: Although pregnancy-associated heart failure with preserved ejection fraction (HFpEF) is increasing and contributing to maternal morbidity, little is known about its impact on pregnancy.

    Risk factors for pregnancy-associated heart failure with preserved ejection fraction and adverse pregnancy outcomes: a cross-sectional study · 2024 · DOI

Most-cited papers in Cardiovascular Issues in Pregnancy

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90 open questions have been extracted from the limitations and future-work passages of 255 Cardiovascular Issues in Pregnancy papers in our 4.5M-paper local library. Each one below links back to the study that raised it, so you can read the original claim in context.

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