Why Heart Disease in Women Is Often Misdiagnosed

Heart disease stands as the leading cause of death for women in the United States, yet a systemic pattern of misdiagnosis and delayed care persists. Many women experience significant delays in receiving treatment because their symptoms are frequently dismissed or misattributed to non-cardiac issues such as stress, anxiety, or musculoskeletal problems.

Research indicates that women experiencing heart attack symptoms are significantly more likely to be misdiagnosed than men. According to research published in the Journal of the American Heart Association, women under the age of 55 were seven times more likely than men to be sent home from the emergency room without receiving proper cardiac testing.

Atypical Symptom Presentation

A primary driver of these diagnostic delays is that women often do not present with the classic chest pain typically associated with heart attacks in men. Because their symptoms do not fit the standard narrative, health professionals may mistake cardiac distress for panic attacks, acid reflux, or gastrointestinal problems.

Common symptoms of heart disease in women include:

• Shortness of breath
• Nausea or vomiting
• Unexplained fatigue
• Pain or discomfort in the jaw, neck, or back
• Lightheadedness or dizziness
• Pain or discomfort in one or both arms

These atypical presentations can lead to women being told their symptoms are just stress or nothing to worry about, which increases the risk of long-term heart damage or death.

Medical Bias and Research Gaps

The disparity in diagnosis is rooted in a long history of medical bias and outdated research. For decades, clinical trials for heart disease focused primarily on men, leaving a substantial gap in medical knowledge regarding how the disease manifests in women.

Nisha Jhalani, MD, a cardiovascular disease specialist at the Vagelos College of Physicians and Surgeons, noted on February 28, 2022, that guidelines used to treat heart disease were derived from studies conducted in the 1990s that were almost exclusively performed on men.

Even in contemporary research, the representation of women remains low, with only about 30% of study subjects being female. This lack of inclusive data contributes to the continued categorization of women’s cardiac symptoms as anxiety or other non-cardiac issues.

Heart disease in women is just not the same as heart disease in men. There’s just something different about a woman’s heart versus a man’s heart.

Nisha Jhalani, MD

Increasing Risks and Prevention

The prevalence of heart disease in women, particularly among younger women, has been increasing over the last 10 years. More women than men die of heart disease every year, yet many women remain unaware of their personal cardiovascular risk or the specific risk factors associated with the disease.

Some women may also delay seeking care due to feelings of shame, embarrassment, or denial. Dr. Jhalani emphasized that delaying the investigation of serious symptoms can be life-threatening.

Despite these challenges, there is a significant opportunity for prevention. Dr. Jhalani stated that 90% of heart disease cases can be prevented through healthier lifestyle choices, allowing individuals to take active control of their heart health.