“It took five years to get a diagnosis”

For five years, Elena experienced recurring episodes of chest pain without knowing what was causing them. The symptoms often appeared without warning, even when she was resting at home. “I thought it was anxiety,” she recalls.

“I’d be sitting on the sofa watching a film and suddenly my chest would start hurting. I'd try to calm myself down and focus on my breathing, but most of the time it didn't help,” she explains.

The episodes kept happening, but for years no one could explain what was causing them.

Eventually, Elena realised something wasn't right. "I thought, 'If this keeps happening even when I'm completely relaxed, something isn't right.'" That day, she made an appointment with her GP and asked to undergo all necessary tests. A CT scan ultimately revealed the cause of her symptoms. 

Why can some diagnoses be delayed? 

Elena’s experience highlights an important issue: in some cases, women with cardiovascular disease may face delays in diagnosis, especially when their symptoms are non-specific or are initially attributed to other causes.

"We use the term 'bias' when there are differences in the medical care people receive, whether in diagnosis or treatment. In conditions such as cardiovascular disease, we've seen over many years that women are often diagnosed later than men. That's why it's essential that the same diagnostic and treatment approaches are used for both women and men,” explains Dr Mercè Roqué.

In addition, Dr Roqué points out that much of the available scientific evidence still comes from studies in which women are underrepresented. This means that research findings cannot always be applied equally to women and men, highlighting the need to incorporate a sex and gender perspective into biomedical research.

Coronary heart disease, including heart attacks, is the leading cause of death in women. 

Yet there are still major gaps in our understanding of how it affects prognosis, complications and quality of life.

When women are excluded from the standard model, their risks are more likely to be underestimated. This can lead to missed or delayed diagnoses, adverse effects and treatments that are less effective

Experts warn that delayed diagnosis is particularly concerning in younger women, for whom early diagnosis is key to starting treatment promptly and reducing the risk of complications.

Beyond chest pain: other symptoms of cardiovascular disease 

Cardiovascular disease can present differently in women than it does in men. Although chest pain is the most common symptom in both sexes, women are more likely to experience additional symptoms, such as shortness of breath, extreme fatigue, nausea, vomiting or dizziness.

In addition, certain types of coronary heart disease, such as spontaneous coronary artery dissection and coronary microvascular dysfunction, are more common in women and often require specific diagnostic tests.

Specialists emphasise the importance of assessing symptoms as a whole and avoiding dismissing them as stress or anxiety without first carrying out the diagnostic assessment best suited to the individual patient.

Why is diagnosis sometimes delayed? 

The way cardiovascular disease presents in women, together with biological, hormonal and social factors, can make diagnosis more challenging.

“Elena’s case was unusual,” explains Dr Mercè Roqué. “However, it’s important to listen carefully to women who report persistent symptoms, review the patient’s medical history and risk factors thoroughly, and not dismiss the possibility of an underlying heart condition.”

Listen to your body and seek medical advice

If you experience recurring chest pain, shortness of breath, extreme fatigue with no obvious cause or other persistent symptoms, it's important to seek medical advice.

Today, Elena shares her story to raise awareness that cardiovascular disease affects women as well as men, and that paying attention to your body can make all the difference. “I kept pushing for answers because I knew something wasn’t right,” she recalls.

Her testimony highlights the importance of early diagnosis and the need to continue integrating a sex and gender perspective into cardiovascular care.