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Why are women more likely to be misdiagnosed when they have heart disease?

Dr. Michael W. Gen, MD
Cardiologist (Heart Specialist)

Women are more likely to be misdiagnosed when they have heart disease in part because symptoms are often unusual and atypical. Because of this, both patients and doctors limit, belittle and even ignore the symptoms. Symptoms are played down, so doctors don’t consider heart disease to be an option. The tests are less accurate and sensitive in women than in men, too. Doctors have to be more aggressive about suspicions of heart disease.

It can be difficult to diagnose heart disease in women. The symptoms of heart attack in some men are similar to the symptoms you see on TV shows or movies. In women, the symptoms are very difficult to distinguish because they are not always typical. They don't have the classic chest pain when coming into the emergency room with a heart attack. I think we all have to be very vigilant when women come in to the ER describing chest pain symptoms.

Women usually come in with symptoms as simple as fatigue. They may say, "You know, I've been feeling very tired over the past few weeks and I can't do what I was normally doing. I may be having some shortness of breath when I'm going up the stairs." These are all very, very atypical symptoms that we've been seeing. When we examine the woman more closely, or if she comes to the ER, it sometimes turns out that she is having a heart attack. Again, the symptoms need to be monitored very closely.

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Dr. Holly S. Andersen, MD
Cardiologist (Heart Specialist)

Chest pain is the most common symptom for a heart attack. But 40% of women who are having a heart attack don't have chest pain. Women having heart attacks are much more likely to have pain in the jaw, back, or arm. They might feel lightheaded or like they have indigestion. 

So, women who believe that they are having a heart attack are far less likely to call 9-1-1.

I see this in my practice all the time. A woman comes in at the end of the day just to have her blood taken and she asks to speak to me. She says that morning she had "an hour and a half of the worst pain" in her life. When asked if she thinks she had a heart attack and what did she do, she replies: "Well, I was just hoping that it would go away."

Don’t sit there and hope that it will go away! All too often, the first sign of heart disease is a heart attack or sudden death. Time is muscle. I’d much rather be taking care of indigestion in the emergency room than missing somebody’s heart attack.

One of the biggest reasons women are misdiagnosed when they have heart disease is that they may not have the classic symptoms of chest pain and shortness of breath. Women sometimes (or at least, more commonly than men) have just fatigue or vague complaints of "not feeling well."

Another reason is that heart disease is less common in women before menopause. So, doctors may not think of it as a cause of your symptoms if you haven't yet reached this phase of life.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.