Heart attacks in women: delays, missed diagnoses and under-treatment

What's on this page

• Why women face misdiagnosis and worse treatment
• How to reduce your risk of a heart attack
• Heart attack symptoms in women
• What to do if you have heart attack symptoms
• How you can help improve heart attack care
• How BHF is helping to improve heart care for women

When Helen Wilberforce (pictured above) had a heart attack in 2023, she could not believe it was happening. She considered herself a healthy 72-year-old and when she found herself in A&E, she joked with the doctor. 

“I teased, ‘Oh, this looks serious,’ as a trolley was wheeled into my bay,” she recalls.

“Then the doctor said, ‘It’s for you. You’ve had a heart attack.’”

Earlier that day she had googled ‘heart attack symptoms’ after struggling to catch her breath and experiencing a strange feeling in the middle of her chest.

“The advice was to call 999 but I didn’t want to make a fuss, so I called NHS 111,” says Helen, who lives in Holmfirth, West Yorkshire.

The responders recognised something serious was happening and called an ambulance that took her to A&E.

Every 16 minutes a woman in the UK is admitted to hospital due to a heart attack

She needed open-heart surgery to bypass the 3 blocked blood vessels (coronary arteries) that had caused her heart attack.

She now realises that the symptoms she did not think were serious were in fact a medical emergency. “If I hadn’t made that call, I could have died,” she says.

• Read more about Helen's story.

Why women face misdiagnosis and worse treatment

Helen is one of the 33,000 women who are admitted to hospital due to a heart attack each year in the UK.

That is the equivalent of one woman every 16 minutes. Yet heart attacks are often seen as being a ‘man’s problem’.

“It’s true more men than women have heart attacks. But just because something is less common does not mean it’s uncommon,” says Dr Sonya Babu-Narayan, British Heart Foundation (BHF) Associate Medical Director (pictured below).

She points out that coronary heart disease, which causes most heart attacks, is the biggest killer of women worldwide, and kills twice as many in the UK as breast cancer each year.

“When it comes to heart attacks, the odds are stacked against women. They are more likely than men to have a delay in being diagnosed or be misdiagnosed,” explains Dr Babu-Narayan.

“Women may be less aware that heart attacks can affect them, or be more hesitant to seek medical help. But even when they do, they are more likely to be dismissed.”

Dr Babu-Narayan points to the example of the AI-powered virtual GP app, Babylon. It made headlines a few years ago because, with the same symptoms and medical history, the algorithm suggested very different courses of action for men and women.

When it comes to heart attacks, the odds are stacked against women.

Men were advised to go to A&E to rule out a heart attack, while women were told they might be having a panic attack, best treated at home. 

“This is an example of an AI algorithm amplifying existing inequalities in women’s treatment,” she says. 

Before becoming a doctor herself, Dr Babu-Narayan witnessed her own mother face such discrimination.

“The last time I saw my mother alive, she was in the cardiac ward, weeping from the pain in her chest. I was told at the time, ‘Indian women always complain about pain.’”

Sadly, inequalities still exist. A study in the journal Heart in 2024 showed that women, Black people and people from low-income households are less likely to be offered heart surgery in England.

And when they do have heart surgery, the results are not as good. Women are more likely to die in the year after heart surgery.

“Women are less likely to have treatments such as stents, heart surgery, medicines such as statins and access to cardiac rehabilitation, which can reduce the risk of a heart attack happening again,” says Dr Babu-Narayan.

“When it comes to heart care, women are under-treated and under-supported.” 

How to reduce your risk of a heart attack

If you are a woman, or you are thinking about your female friends and relatives, BHF wants to empower you.

We want to help you understand your risk, recognise the symptoms of a heart attack, and know how and when to get medical help: 

Heart attack risk factors for women and men include if:

• You have high blood pressure, high cholesterol or uncontrolled diabetes.
• You smoke, have an unhealthy diet, or drink more than 14 units of alcohol per week.
• You are not physically active.
• You have a family history of heart disease.

For women, smoking or having diabetes is linked with an even greater risk of having a heart attack than for men, so there’s even more reason to try to quit smoking and keep diabetes in check.

There are also other risks specific to women. 

“Having periods early, recurrent still births or miscarriages, experiencing diabetes or high blood pressure during pregnancy, or going through menopause early could put you at a higher risk,” says Dr Babu-Narayan. 

Doctors do not routinely ask about these factors when assessing women’s risk, she explains.

Therefore, women might want to bring these factors up when talking to their doctor.

She also points out that when oestrogen levels drop leading up to, during, and after menopause, cholesterol levels, weight and blood pressure can rise, putting you at greater risk.

This is a time to keep a closer eye on your health by checking these levels.

Find out more about menopause and the heart in our Live & Ticking webinar (below).

Heart attack symptoms in women

Heart attacks do not always look like they do on television, with someone dramatically clutching their chest in agony. It’s also a common misconception that women and men experience different heart attack symptoms.

Research, funded by BHF, shows that both men and women can have a range of symptoms, including:

• chest pain or discomfort that may feel like pressure, tightness, gripping, squeezing, aching, or heaviness on the chest that comes on suddenly and does not go away
• pain or discomfort that may spread to one or both of your arms, or your neck, jaw, back or stomach
• shortness of breath 
• feeling dizzy or lightheaded
• a feeling that is similar to indigestion, feeling sick (nausea), or being sick (vomiting)
• sweating
• a sudden feeling of anxiety that can feel like a panic attack. 

If you think you’re having a heart attack, call 999 immediately.

What to do if you have heart attack symptoms

“Do not dismiss your symptoms. Even if it’s a false alarm, it’s better to be reassured,” says Dr Babu-Narayan. 

She says that if you think you might be having a heart attack, say so. 

“This will trigger others to consider it, whether it’s your family who may need to call for help, paramedics in the ambulance, or doctors at the hospital. 

“If you feel you are not being heard, do not feel shy to say it twice, or perhaps ask the doctor, ‘How do you know I am not having one?’”

This is an approach Nicola Topping (pictured above), from Linlithgow, near Edinburgh, wishes she’d taken.

In November 2017, the then 47-year-old called an ambulance. She had chest discomfort, was hot and sweaty and had an upset stomach.

The paramedics told her she was not having a heart attack, and she was not taken to hospital.

When the indigestion tablets did not work, she persisted in seeking answers and eventually, 18 months later, was seen by her usual doctor, who had returned from maternity leave. 

It’s not always the gripping pain you see in movies.

A referral to a heart specialist, “just to rule things out”, led to a diagnosis of angina.

“I was told from what they could see, and what I told them, I probably did have a heart attack that night the paramedics came.

"They said an upset tummy and clamminess can be symptoms. It’s not always the gripping pain you see in movies.” 

She says, “If I could go back, I would have asked more questions, I would have pushed to go to the hospital sooner. When someone in a more educated position tells you, ‘You’re 
definitely not having a heart attack’, you want to accept that.

“But I knew something wasn’t right. I think, as women, we’re sometimes too accepting.”

• Read more about Nicola's story.

How you can help improve heart attack care

Current guidelines about how best to diagnose and treat heart attacks have been developed through decades of research.

However, only about a third of participants in studies into heart and blood vessel (cardiovascular) disease are women. 

More women are needed, says Dr Babu-Narayan. “If you’re asked to take part in a trial, perhaps consider it. Do not be afraid to ask questions and find out more.”

• Learn more about taking part in research.

How BHF is helping improve heart care for women

Fighting for fairer research

We use our position as one of the world’s biggest funders of cardiovascular science to increase women’s representation in research. 

Since 2021, any scientist applying for our funding has to explain how they will recruit a representative range of participants and our new application forms include a section on male and female representation in the study. 

Promoting women in science

Within a generation, we want to see an equal number of men and women scientists being funded. We support women’s careers in cardiology, for example by hosting Women in Science events.

It’s about moving beyond ‘bikini medicine’, the idea that women’s health is only about breasts and ovaries.

Dr Babu-Narayan says: “We know when there are both women and men in the team, more women are recruited into trials. Diverse teams with diverse ways of thinking also lead to better research and innovation.”

Raising awareness

Through information such as this article, which you can help us share with friends and family, we support women to understand their risks, the symptoms of heart attacks, and when to call for urgent help.

Influencing the government and NHS

Since 2019, our policy teams have put out Bias and Biology reports for England, Scotland, Northern Ireland and Wales, which highlight gender inequalities in heart care and call for improvements.

This has helped influence government plans, for example the Scottish Women’s Health Plan for 2021-24 included clear aims and actions for women’s heart health.

“It’s about moving beyond ‘bikini medicine’, the idea that women’s health is only about breasts and ovaries,” explains Dr Babu-Narayan.

“Changing entrenched inequalities and biases will not be easy, but it will be worthwhile.” 

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