Cedars-Sinai Blog

Heart Attacks in Women Could Be Flying Under the Radar

A new Cedars-Sinai study shows that women who complain of chest pain but don't have coronary artery blockages could have experienced undiagnosed heart attacks.

Women who complain about chest pain often are reassured by their doctors that there's no reason to worry because their angiograms show no blockages in the major heart arteries, a primary cause of heart attacks in men.

"Too often, women are told they don't have a heart problem and they are sent home instead of receiving appropriate medical care."

But a National Institutes of Health study led by investigators at the Barbra Streisand Women's Heart Center in the Smidt Heart Institute shows that about 8% of those women actually have scars on their hearts that indicate they experienced a heart attack.

"This study proves that women need to be taken seriously when they complain of chest pain, even if they don't have the typical symptoms we see in men," says Dr. Janet Wei, lead author of the study.

"Too often, these women are told they don't have a heart problem and they are sent home instead of receiving appropriate medical care."

The study looked at women who had complained of chest pain and had no coronary artery blockages.

  • Of the 340 women in the study who underwent cardiac magnetic resonance (CMR), a detailed imaging scan of the heart, 8% were found to have myocardial scar, which indicates heart muscle damage.
  • Approximately one-third of those women with myocardial scar were never diagnosed with a heart attack, even though their cardiac scans indicated they had heart muscle damage.
  • Of the 179 women who underwent a one-year follow-up CMR, 1% were found to have myocardial scar that wasn't there the year before; these women had been hospitalized for chest pain in the year since their initial scan, but had not been diagnosed with heart attacks.

The study is part of the ongoing Women's Ischemic Syndrome Evaluation (WISE) research project sponsored by the National Heart, Lung, and Blood Institute.

"Many women go to the hospital with chest pain but they often aren't tested for a heart attack because doctors felt they were low-risk," says Dr. Noel Bairey Merz, director of the Barbra Streisand Women's Heart Center and primary investigator of the WISE study.

"And they are considered low-risk because their heart disease symptoms are different than the symptoms men experience."

"We are finding that either these women are not being tested because doctors think they are at low-risk or that the tests doctors are ordering are not picking up these small heart attacks," Dr. Wei says.