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Historically, the focus of the diagnostic evaluation for symptomatic women and men has been the detection of an obstructive coronary stenosis requiring revascularization (as appropriate). Two challenges to this approach have resulted in revision of this evaluation algorithm and provided added insight into the burden of atherosclerosis and overall hazard for IHD events in women. First, recent clinical trial data have revealed that prompt guideline-based medical management is safe and that revascularization may be deferred for women and men with stable IHD (SIHD). 7, 8 Strategies of either revascularization with optimal medical therapy or optimal medical management alone are effective at reducing the burden of angina for SIHD patients. 9 Second, there is unfolding evidence of the clinical and prognostic significance of nonobstructive CAD, detected by intravascular ultrasound or CCTA. 10–18 Although it affects …