A major international review has found serious gaps in how heart attacks are diagnosed and treated in women, especially in those under 50.
The American Heart Association (AHA) has released a new scientific statement highlighting that current medical practices may be failing young women with heart disease. The statement, led by Australian cardiologist Professor Jason Kovacic, is published in the journal Circulation.
Heart disease is the number one killer of people worldwide and the second leading cause of death in Australia. But premenopausal women—those typically under age 50—face a higher risk of being misdiagnosed or not getting the treatment they need for heart attacks.
These women often don’t match the typical heart attack patient profile, which is based on older men. As a result, they are more likely to suffer serious complications or even die compared to men their age.
Professor Kovacic, CEO of the Victor Chang Cardiac Research Institute, warned, “Too many women are missing out on timely diagnosis and treatment because the system isn’t built to recognize them properly. We urgently need to fix this.”
The AHA statement calls for several major changes:
Better public and medical awareness about how heart attacks can look different in women.
More women included in clinical research and trials to better understand and improve their care.
Faster and more accurate diagnosis for younger women with heart symptoms.
One major issue is that the current medical guidelines don’t fully account for the different types of heart attacks that occur in younger women. Many of these women do not have typical risk factors like high blood pressure, high cholesterol, or blocked arteries, so their heart attacks may be missed or misunderstood.
Two examples of these lesser-known conditions are:
Spontaneous coronary artery dissection (SCAD): A tear in a heart artery. It’s the top cause of heart attacks in women under 50, making up around 25% of cases in that group.
Myocardial infarction with nonobstructive coronary arteries (MINOCA): A heart attack without any major artery blockages showing on scans.
These conditions are serious, yet they are underrepresented in medical training and guidelines. Because of that, many women don’t receive the right diagnosis or treatment when they show up at the hospital with symptoms.
“We see a lot of cases in younger women that don’t match the classic heart attack signs doctors expect,” said Professor Kovacic. “We need more research focused on women and better clinical guidance to make sure all women get the care they need.”
Another problem is that many women don’t recognize their own symptoms, which are often different from the well-known chest pain.
Women may feel pain in the jaw or back, feel sick, sweat, feel very tired, or just feel “off.” These signs are easy to miss at home or even in the emergency room. Raising awareness and improving emergency care procedures could save lives.
The AHA statement also stresses the need for strong follow-up care. That includes addressing ongoing risk factors, managing heart problems related to pregnancy, and providing support for depression or anxiety after a heart attack. Cardiac rehabilitation is especially helpful for recovery and long-term health.
Professor Kovacic says this new statement is a powerful call to action. “We know where the gaps are—we just need to close them. Heart disease can affect anyone, and young women deserve fast, accurate, and equal care when they have a heart attack.”
If you care about heart health, please read studies about top 10 foods for a healthy heart, and how to eat right for heart rhythm disorders.
For more health information, please see recent studies about how to eat your way to cleaner arteries, and salt and heart health: does less really mean more?
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