Medically reviewed by Dr Nabila Laskar, Consultant Cardiologist (GMC 7040901). Heart disease is the leading cause of death in women, yet symptoms are more often atypical, under-recognised and under-investigated than in men.
Women more frequently present with breathlessness, unusual fatigue, nausea, jaw, neck or back discomfort, and chest tightness that is not clearly exertional — rather than the classic crushing central chest pain. See /conditions/breathlessness and /conditions/chest-pain.
Pre-eclampsia and gestational diabetes, polycystic ovary syndrome, early menopause, autoimmune conditions such as lupus and rheumatoid arthritis, and migraine with aura all raise cardiovascular risk and are frequently omitted from standard risk scores.
Falling oestrogen levels around the menopause are associated with rising blood pressure, adverse changes in cholesterol and increased visceral fat. This is a key window for cardiovascular risk assessment — see /cardiometabolic-clinic.
Coronary microvascular dysfunction and INOCA (ischaemia with non-obstructive coronary arteries), spontaneous coronary artery dissection (SCAD) and takotsubo syndrome are all more common in women and are frequently missed by tests focused only on large-vessel narrowing.
They can be. Women more often report breathlessness, fatigue, nausea and pain in the jaw, neck or back rather than classic central chest pain, which contributes to delays in diagnosis. Any suspected heart attack is a 999 emergency.
Cardiovascular risk rises around and after the menopause as blood pressure and cholesterol tend to worsen. This makes the perimenopausal years an ideal time for a formal cardiovascular risk assessment.
Yes. Microvascular angina and INOCA involve the very small vessels of the heart, which are not visible on standard angiography. They are real, treatable conditions and are more common in women.
It is entirely a matter of preference — many women simply feel more comfortable discussing symptoms with a female consultant. What matters clinically is that your symptoms are taken seriously and properly investigated.