Heart disease kills more women than any other disease, but symptoms aren’t always obvious

Heart disease remains the leading cause of death for women in the United States according to U.S. Centers for Disease Control and Prevention, yet many women still do not recognize the warning signs, partly because symptoms often look different than they do in men.

"Heart disease is not just a 'man's disease,' and women should never ignore symptoms simply because they don't match the textbook description," says Purvi Parwani, MD, Director of the Women's Heart Health Clinic at Loma Linda University Health. "Listen to your body, prioritize your health, and know that early recognition and prevention can save lives."

While chest pain is still the most common symptom of heart disease in both men and women, women are more likely to experience additional symptoms that can appear vague or unrelated. These may include shortness of breath, unusual fatigue, nausea, dizziness, palpitations, or pain in the jaw, neck, back, or upper abdomen.

"A lot of women describe feeling unusually tired for weeks, getting winded more easily, or just feeling 'off,'" Parwani says. "Symptoms like indigestion, nausea, back pain are frequently dismissed as stress, hormonal changes, or simply being overworked in women."

Why this is often missed in women

According to Parwani, heart disease in women is often diagnosed later because women tend to present with more subtle symptoms and conditions that are harder to detect through traditional testing. Historically, cardiovascular research also focused largely on men, shaping the medical community's understanding of what "typical" heart disease looks like.

Women are more likely to develop conditions such as microvascular disease and coronary artery spasms, which affect the smaller blood vessels of the heart and may not appear on routine stress tests or standard cardiac catheterization.

Advanced cardiovascular imaging can help uncover those hidden problems. Tests such as stress cardiac MRI, coronary CT angiography, and cardiac PET imaging allow specialists to identify inflammation, scar tissue, plaque buildup, and microvascular dysfunction that may otherwise go undetected.

Certain heart conditions are also more common in women but remain less widely recognized, including spontaneous coronary artery dissection (SCAD), microvascular angina, and Takotsubo cardiomyopathy, often called "broken heart syndrome."

Women face unique risk factors

Experts also warn that several risk factors unique to women are frequently overlooked. Pregnancy-related complications such as preeclampsia, gestational diabetes, high blood pressure during pregnancy, and preterm delivery can all increase future cardiovascular risk. Autoimmune disease, early menopause, and polyendocrine metabolic ovarian syndrome (previously known as polycystic ovarian syndrome or PCOS) may also raise risk.

Parwani encourages women not to ignore persistent symptoms, even if they seem mild.

"Your body often gives subtle warning signs before a major event happens," Parwani says. "If something feels different or keeps recurring, it's worth getting evaluated rather than assuming it's stress or exhaustion."

What women can do

Women can lower their risk by knowing their blood pressure, cholesterol, blood sugar, and family history while prioritizing exercise, sleep, nutrition, and stress management.

To learn more about heart care services or schedule an evaluation with a cardiovascular specialist, visit Loma Linda University International Heart Institute Women's Heart Health Clinic webpage.