Why is Women’s Heart Disease Misdiagnosed?

Women with more frequent chest pain symptoms, including those associated with stressful circumstances and those occurring during activities of daily living or household tasks, should receive more intensive evaluation.

  • Heart disease is the leading cause of death for women in the United States. In 2006, 315,930 women died from it.


  • Heart disease killed 26% of the women who died in 2006, more than one in every four.


  • Although heart disease is sometimes thought of as a “man’s disease,” around the same number of women and men die each year of heart disease in the United States. Unfortunately, 36% of women did not perceive themselves to be at risk for heart disease in a 2005 survey.


  • Almost two-thirds of the women who die suddenly of coronary heart disease have no previous symptoms. Even if you have no symptoms, you may still be at risk for heart disease.


Nine out of ten heart disease patients have at least one risk factor. Several medical conditions and lifestyle choices can put women at a higher risk for heart disease, including:

  • High cholesterol
  • High blood pressure
  • Diabetes
  • Cigarette smoking
  • Overweight and obesity
  • Poor diet
  • Physical inactivity
  • Alcohol use


At Heal n Cure, our INSPIRE core wellness program targets improvement of all of the above risks factors.

Based on our experience treating thousands of Men & Women under the INSPIRE – “Core Wellness Program,” we have observed that the fat distribution on the Male body is concentrated on the abdominal region, whereas in Women, the fat gets distributed somewhat evenly throughout the body – arms, chest, upper abdomen, lower abdomen, hips, thighs.

Similarly, men and women can have coronary artery disease in which main, large arteries are plugged up by fatty, athlerosclerotic plaques. These blockages greatly increase the risk of a heart attack, sudden cardiac arrest, stroke and heart failure. But far fewer women show up with this “classic” form of heart disease.

When it comes to acute heart attacks and sudden death, women have these kinds of events much more often without any obstructions in their coronary arteries. Instead, it appears that a significant portion of women suffer from another form of heart disease altogether, one that affects not the main coronary arteries but rather the smaller arteries, called microvessels, that deliver blood directly to the heart muscle tissue. This is called microvascular disease. What researchers are learning about this new form of heart disease may explain why some patients experience different heart-related symptoms and why women, as a group, have higher mortality and poorer outcomes from the suite of disorders that make up cardiovascular disease.

There are two kinds of heart disease that appear to be more common in women:

1. Non-obstructive heart disease (including vasospasms like Prinzmetal’s variant angina)

2. Single-vessel disease (up to 99% blockage, with no other artery obstructions visible in the cath lab – different from those (male) quintuple bypass patients)

Part of the serious issue seems to be that both cardiac diagnoses can be missed entirely using conventional diagnostic tools (that have been developed and researched mostly on males). The treadmill stress test is a perfect example, considered approximately 80% accurate in identifying heart disease in men, but as low as 40% accurate for females, producing both false negatives and false positives.

Prescribing a diagnostic test that can be wrong up to 60% of the time, might be described as downright useless. Microvascular disease can be difficult to diagnose using conventional diagnostics despite the presence of significant cardiac symptoms. It’s purely a diagnosis of eliminating all other possibilities. Female patients are sometimes sent home from the E.R. in mid-heart attack with “normal” test results and misdiagnoses ranging from acid reflux to anxiety or gallbladder problems.

A more advanced test exists that will detect these two kinds of heart disease that appear to be more common in women.  That test is the Cardiopulmonary Exercise Test (CPET), which is administered at Heal n Cure. This advanced stress test is able to detect the beginning stages of heart disease at the vascular bed in men and women. This allows physicians to diagnose and treat symptoms correctly, which leads to better patient care and overall health.

Due to the current testing mechanisms for detecting heart disease, female patients are being sent home every day from the E.R. in mid-heart attack with “normal” test results and misdiagnoses ranging from acid reflux to anxiety or gallbladder problems. The CPET and other technologies of its’ kind must be utilized in order to reverse heart disease symptoms and prevent these less “classic” forms of heart disease from progressing to heart attack and death.

New insights into ischemic heart disease in women
Gender Differences in Heart Disease