Unrecognized Heart Disease in Women: The Silent Threat of Infradiagnosis

Women’s Heart Health: A Critical Gap in Diagnosis and Treatment

Madrid, Spain – August 30, 2025 – Cardiovascular diseases remain the leading cause of death for women globally, yet a significant disparity exists in their diagnosis and treatment compared to men. Recent discussions at the World Congress of Cardiology have highlighted a concerning trend: women’s heart conditions are frequently overlooked,misdiagnosed,and undertreated,frequently enough attributed to a ancient bias in medical research and a lack of awareness among both patients and healthcare providers.

The Historical Roots of the Disparity

The issue stems, in part, from the 1970s, when the landmark Multiple risk Factor Intervention trial exclusively studied over 325,000 men, offering no data on women. This led to decades of cardiovascular research and preventative strategies focused primarily on male physiology. The study, dubbed “Mr. Fit,” created a considerable foundation of evidence, but its limited scope left a critical gap in understanding heart disease in women. Experts now acknowledge this initial imbalance as a significant source of ongoing bias.

Underdiagnosis and the Dismissal of Symptoms

Recent findings indicate that a staggering 50% of women experiencing early warning signs of heart disease – such as palpitations and shortness of breath – do not seek medical attention. Manny wrongly attribute these symptoms to menopause, delaying possibly life-saving interventions. A 2022 United States study revealed Black women, in particular, waited an average of 11 minutes longer than men to receive care for chest pain and were less likely to be immediately assessed as urgent cases.

“Decades of campaigns have increased awareness of women’s health, but stagnation persists in reducing the global burden of cardiovascular disease,” stated a recent report from The Lancet commission. this underscores the urgent need for continued effort and systemic change.

Distinct Symptoms and Treatment Challenges

Heart disease manifests differently in women than in men, complicating diagnosis. While men typically experience crushing chest pain, women are more likely to present with symptoms like nausea, fatigue, and pain in the neck or jaw. This atypical presentation can lead to misdiagnosis, with some women being incorrectly diagnosed with anxiety or other mental health conditions. A 2009 study showed women experiencing heart disease symptoms were twice as likely as men to be diagnosed with a psychological disorder.

Moreover, women are more prone to developing heart failure with preserved ejection fraction (HFpEF), a condition characterized by breathlessness, fatigue, and swelling despite normal heart pumping function. This type of heart failure requires specialized treatment approaches that are not yet universally implemented in clinical practice.

Characteristic	Men	Women
Typical Heart Failure Type	Systolic (pump dysfunction)	Diastolic (hfpef)
Common Symptom	Oppressive chest pain	Nausea, fatigue, jaw pain
Misdiagnosis Risk	Lower	Higher (often mental health)

Did You Know? Pregnancy-related hypertension substantially increases a woman’s risk of developing heart failure later in life, potentially quadrupling their risk near menopause.

The Need for inclusive Research and Training

Experts are calling for a essential shift in medical research to include more women and diverse ethnic groups in clinical trials.Dr. alta Schutte, a researcher at The george Institute for Global Health, pointed out that even basic laboratory studies often fail to specify the sex of cells used, with a disproportionate focus on male cells – a practice that can skew our understanding of fundamental physiological differences.

Training for medical professionals also needs to evolve to address this bias. Significantly, as recently as 2024, 78% of the signatories on guidelines from the European Society of Cardiology were men, illustrating a continuing lack of diverse perspectives in the advancement of treatment protocols.

Pro Tip: If you are a woman experiencing any unusual symptoms like unexplained fatigue,shortness of breath,or discomfort in your chest,jaw,or back,do not dismiss them. Seek medical attention and specifically discuss your concerns about heart health with your doctor.

Staying Ahead of Heart health Risks

Maintaining a heart-healthy lifestyle is crucial for everyone, but notably vital for women. This includes regular exercise, a balanced diet low in saturated and trans fats, managing stress, and controlling blood pressure and cholesterol levels. Emerging research also suggests a strong link between gut health and cardiovascular function, emphasizing the importance of a fiber-rich diet and probiotic intake.

Frequently Asked Questions about Women and Heart Disease

Q: Why are women frequently enough misdiagnosed with heart conditions?

A: Women often experience atypical symptoms that differ from the “classic” chest pain typically associated with heart attacks in men,leading to misdiagnosis or delayed treatment.

Q: What is HFpEF, and why is it more common in women?

A: Heart failure with preserved ejection fraction (HFpEF) is a type of heart failure where the heart can pump normally, but struggles to fill with blood. It is more common in women due to hormonal and physiological differences.

Q: How did historical medical research contribute to the disparities in women’s heart health?

A: Early landmark studies on heart disease, like the Multiple Risk Factor Intervention Trial, primarily focused on men, creating a gap in knowledge about how heart disease presents and progresses in women.

Q: What can I do to help ensure I receive an accurate diagnosis if I suspect a heart problem?

A: Be proactive in communicating your symptoms to your doctor, specifically mentioning your concerns about heart health and any family history of cardiovascular disease.

Q: Is it true that pregnancy can impact a woman’s long-term heart health?

A: Yes, hypertension during pregnancy can increase a woman’s risk of developing heart failure and other cardiovascular problems later in life.

What steps do you think healthcare providers can take to address this gender bias in heart health? Share your thoughts in the comments below!

How does the historical underrepresentation of women in clinical trials impact the accuracy of current heart disease diagnostic criteria for females?

Why Women’s Heart Disease is Often Missed

For decades, heart disease has been perceived as a “man’s disease.” This deeply ingrained bias has led to notable underdiagnosis and undertreatment of cardiovascular conditions in women. The reality is, heart disease is the leading cause of death for both men and women. However, the presentation of heart disease often differs significantly between sexes, contributing to the infradiagnosis. Women are more likely to experience atypical symptoms, leading to delays in seeking medical attention and, crucially, misdiagnosis by healthcare professionals.

This isn’t simply a historical oversight. Ongoing systemic issues within medical research and practice continue to contribute to the problem.Clinical trials historically included fewer women, meaning data on female-specific cardiovascular responses were limited. This impacts everything from diagnostic criteria to treatment protocols.

Atypical Symptoms: Recognizing the Red Flags

Customary heart attack symptoms – chest pain radiating down the left arm – are often what people picture. While women can experience these, they are far more likely to present with less “classic” signs. Recognizing these atypical symptoms is vital for early detection.

Here’s a breakdown of symptoms women commonly experience:

Shortness of breath: Frequently enough occurring without chest pain.

Nausea or vomiting: Frequently mistaken for the flu or indigestion.

Fatigue: Unusual or extreme tiredness, even after rest. This is a notably insidious symptom as it’s easily dismissed.

Jaw, neck, or back pain: Pain that isn’t localized to the chest.

Dizziness or lightheadedness: Feeling faint or unsteady.

Indigestion or heartburn: Symptoms mimicking gastrointestinal issues.

Unusual anxiety or a sense of impending doom: A feeling that something is seriously wrong.

it’s crucial to remember that these symptoms can occur individually or in combination. Don’t dismiss them as “just stress” or “normal aging.” Listen to yoru body.

Specific Cardiovascular Conditions Affecting Women

Beyond the typical coronary artery disease, several conditions disproportionately affect women or present differently in women.

Coronary Microvascular Disease (CMVD)

CMVD affects the small arteries of the heart.It’s often harder to detect with standard tests like angiograms.Symptoms include chest pain,shortness of breath,and fatigue. Diagnosis often requires specialized testing like a cardiac CT scan or assessment of coronary flow reserve.

Spontaneous Coronary Artery Dissection (SCAD)

SCAD is a tear in a coronary artery wall. It’s a relatively rare but serious condition, more common in women, particularly those who are pregnant or postpartum. Symptoms mimic a heart attack, but the cause is different.

Broken Heart Syndrome (Takotsubo Cardiomyopathy)

Triggered by intense emotional or physical stress, this condition causes a temporary weakening of the heart muscle. While often reversible, it can be life-threatening. Women are significantly more likely to experience Broken Heart Syndrome than men.

Peripartum Cardiomyopathy (PPCM)

This rare form of heart failure develops during the last month of pregnancy or within five months after childbirth. Early diagnosis and treatment are critical.

The Impact of Hormonal Changes

Hormonal fluctuations throughout a woman’s life significantly impact cardiovascular health.

Estrogen: Historically thought to be protective, estrogen’s role is complex. While it can have beneficial effects on cholesterol levels, its protection diminishes after menopause.

Menopause: The decline in estrogen increases the risk of heart disease. Changes in cholesterol, blood pressure, and blood vessel function contribute to this increased risk.

Pregnancy: Pregnancy puts significant strain on the cardiovascular system. Pre-existing heart conditions can worsen, and new conditions like PPCM can develop.

polycystic Ovary Syndrome (PCOS): Women with PCOS have an increased risk of heart disease due to insulin resistance, obesity, and other metabolic factors.

Diagnostic Challenges & What Tests Are Important

Traditional cardiac testing isn’t always sensitive enough to detect heart disease in women.

Electrocardiograms (ECGs): May not show abnormalities in women experiencing atypical symptoms.

Stress Tests: Can be less accurate in women due to differences in heart size and physiology.

Angiograms: May miss CMVD, as it affects smaller vessels.

More advanced testing may be necessary:

Cardiac CT Scan: Can detect calcium buildup in arteries and assess coronary artery anatomy.

Echocardiogram: Provides images of the heart muscle and valves.

Coronary Flow Reserve (CFR): Measures blood flow to the heart muscle.

QTc Interval Calculation: (Using tools like the [Mayo Clinic qtc Calculator](https://www.mayoclinic.org/medical-professionals/cardiovascular-diseases/calculators/corrected-qt-interval-qtc-calculator/itt-204