Moreover, clinicians are often guided by misconceptions and biases that serve to deprive patients of potentially beneficial therapies. ACCF/AHA guidelines for the management of patients with UA/NSTEMI4,4a address special subgroups by recommending that diagnostic, pharma- cological and revascularization strategies be congruent with those in men, the young, and those without diabetes mellitus. This section echoes those management recommendations. Although this section will briefly review some special con- siderations in diagnosis and therapy in certain groups of patients, the general approach should be to apply the recom- mendations in this guideline consistently among groups. Women generally have a lower incidence of SIHD than men until older age, but their outcomes after MI are worse.1125 Microvascular disease, typically with preserved LV function, is more common among women, particularly those who are younger, whereas obstructive epicardial CAD is less preva- lent. Up to 50% of women with typical or atypical anginal symptoms undergoing cardiac catheterization are found not to have obstructive CAD.1126,1127 Contrary to earlier percep- tions, the prognosis of women with chest pain and nonob- structive disease is not necessarily better.1128,1129 As women age, the prevalence of obstructive CAD increases. Stable angina is the most frequent initial manifestation of SIHD in women, as opposed to AMI and sudden death in men.35,1130 Atypical chest pain and angina-equivalent symp- toms such as dyspnea are more common in women, although women still present with similar patterns, duration, and frequency of symptoms. The lower prevalence of obstructive disease in conjunction with technical challenges makes the interpretation of ischemia on imaging studies somewhat more difficult. 