Doctors Keep Missing Heart Attacks in Women — Here Are the Signs to Watch For

Woman clutching chest

Women are often told that their symptoms are imaginary.

Heart disease is the number one cause of death in America for men and women, yet a lack of research on how women are affected is putting them at serious risk. Women are often told that their symptoms are imaginary, and are twice as likely as men to be diagnosed with a mental illness when presenting signs like chest pain.

As cardiology experts put a spotlight on this issue, here’s what you need to know, and some of the warning signs to watch out for.

What’s the issue?

Leading doctors have warned that knowledge gaps about how heart disease affects women are leaving half the population vulnerable to potentially deadly health events that may go undetected. In a presidential advisory from the American Heart Association, experts note that women are grossly underrepresented in research on heart disease, even though it’s the leading cause of death for women in the U.S.

“We are losing ground on key indicators of cardiovascular health among women, including blood pressure control, weight management and diabetes,” said Dr Véronique Roger per The Guardian.

Roger explained that when we compare data for women with that of men, we characterize men as the “gold standard,” meaning that symptoms associated with women are then considered “atypical” — even though they may be very common in female sufferers. Such beliefs underpin the assumption that heart disease presents in the “wrong way” in women.

As a result, doctors are more likely to tell women that their symptoms aren’t related to their heart, and as the New York Times notes, often dismiss them as imaginary. The assumption that women’s symptoms are “all in their head” leads to twice as many women as men being diagnosed with mental illness, when they complain of the same cardiovascular symptoms.

What are some under-recognized symptoms of heart disease in women?

Women are much less likely than men to feel chest pain during a heart attack. Per the American Heart Association, this puts them at a far higher risk, as doctors take longer to pinpoint the problem, and patients often delay seeking treatment in the first place.

According to the New York Times, some of the less-recognized symptoms that can alert to heart attacks in women include jaw pain, back pain, fatigue, shortness of breath, malaise, and cold sweats.

What are some under-recognized risks for heart disease in women?

Per The Guardian, factors for heart disease that are specific to women include beginning menstruation before 11 years old, reaching menopause before the age of 40, having an unpredictable menstrual cycle, and having irregular ovulation due to hormone imbalances — like that seen in women with PCOS.

Women are more likely to suffer from inflammatory and autoimmune disorders like lupus and rheumatoid arthritis, as well as depression and anxiety, which are all risk factors for heart disease. Treatments for breast, uterine and ovarian cancer are also associated with a higher risk, as is the use of oral contraceptives, and HRT.

Preeclampsia, which presents with high blood pressure, and gestational diabetes during pregnancy are also risk factors for heart disease, which is a huge risk considering the potential impact on a baby’s health.