Chest pain is the most common symptom of heart disease in both men and women. But how that pain presents may differ dramatically between the sexes. Men typically experience substernal chest pain that radiates down the left arm. But many women describe a heaviness in the shoulder, jaw, neck, back, throat, or teeth, and not in the chest. They experience nausea, vomiting, and shortness of breath more frequently than the chest pain pattern typical of men.
Women are also more likely to have intermittent pain or no pain at all.
Diagnostic tests have varying rates of reliability in women. Among the least reliable are the exercise stress test and the ventriculogram, both of which have high false-negative rates in women. The thallium stress test is also more reliable than the exercise stress test. Women may respond differently than men to certain cardiac drugs. For example, women have more complications and a slightly higher mortality rate after receiving thrombolytic therapy.