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Taking a Closer Look: Women and Heart Disease

January 20, 2023 Posted in: Heart Health

Cardiovascular disease is the leading cause of death for both men and women in the United States. While the cardiovascular system anatomy is the same for men and women, unique hormones cause the blood vessels of men and women to function differently.

Overall, doctors generally use the same criteria to diagnose men and women with heart disease, however, there are several nuances to the diagnostic workup that your doctor may consider. Women can experience symptoms of heart disease differently than men – and historically many women were not heard or validated when reporting symptoms of heart attack and cardiovascular disease, leading to critical delays in diagnosis and treatment.

Here at The Chattanooga Heart Institute, our priority is to be a leader in the diagnosis and treatment of women experiencing cardiovascular symptoms. How do we accomplish this goal? By listening to our patients and thoughtfully evaluating them – regardless of their gender.

It’s important to keep in mind that there are nuances when diagnosing women with heart disease. One example of the nuances in diagnosing women is with nuclear stress testing, which can be technically challenging because breast tissue may interfere with the doctor’s view of the heart. This may require more advanced testing like a cardiac PET scan or specialized cardiac CT. Treadmill testing for women has a higher tendency to be falsely abnormal, which means the abnormal result isn’t due to underlying cardiac disease.

Women may also be more likely to have “microvascular” coronary heart disease, which can affect diagnosis. Coronary artery disease is plaque formation in the vessels that supply the heart with blood, which can cause chest pain called angina when the plaque causes a significant blockage of the vessels. “Microvascular” coronary artery disease occurs when there is disease in blood vessels that are too small to see on traditional studies (i.e. arteriograms/angiograms). Because women are more likely to have microvascular disease that is difficult to see on traditional imaging, many providers may miss the diagnosis of this form of disease in their female patients.

Advanced imaging at The Chattanooga Heart Institute

Thankfully, there are emerging ways to assess microvascular coronary artery disease, including measurement of blood “flow reserve” with equipment known as cardiac PET scanners – although not every hospital is equipped with this special technology. The Chattanooga Heart Institute uses the very latest diagnostic tools like cardiac PET, cardiac MRI and others, which allow us to successfully and correctly diagnose patients with microvascular heart disease. These testing capabilities greatly improve our ability to care for female patients experiencing symptoms or are at risk for heart disease.

Call The Chattanooga Heart Institute at (423) 697-2000 to schedule an appointment. For more information, visit

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