While women, especially premenopausal women, have significantly less heart disease than men, they are often at a disadvantage when it comes to diagnosing possible heart disease. Doctors don't have a high index of suspicion when a woman presents with chest pain because most of the time it is due to causes other than atherosclerotic coronary heart disease.
Women do get angina, however, and they do have heart attacks.
It is important to know what the risk factors are for coronary heart disease so that women are more likely to have the recommended diagnostic studies and thus earlier diagnosis. Risk factors for coronary heart disease are generally divided into minor, intermediate and major. They usually would undergo cardiac catheterization unless they had stable or infrequent angina and had never had prior stress imaging. In that case they would undergo the stress imaging first and if that were negative, they would not have a cardiac catheterization at that time. The evaluation of chest pain in women.