Diagnosing heart disease in women can be a challenge. Women often don't realize that their symptoms are caused by a heart problem. Also, the tests to determine if their symptoms are from coronary heart disease are not as reliable as they are for men.

Typical symptoms are:

• Classic crushing chest pressure below the breastbone with pain and tingling down the left arm, accompanied by profuse sweating, shortness of breath, and lightheadedness.

Men are more likely to describe symptoms similar to these. Women with coronary heart disease can surely have these same symptoms. But they often have what doctors refer to as "atypical" symptoms. They might experience:

• New episodes of fatigue
• Shortness of breath
• Insomnia
• Indigestion
• An anxious feeling

These non-specific symptoms have many other possible causes, whereas crushing chest pressure with physical exertion or emotional stress makes doctors think about a heart-related cause immediately.

Even when doctors suspect that a woman's symptoms may be due to coronary heart disease, making a definitive diagnosis can be more challenging compared to a man.

According to the American Heart Association, there are multiple possibilities for the differences in heart care between men and women:

• Most of the original cardiovascular research studies were conducted on men. The design of newer studies should yield results that provide more information about women.
• Women tend to have heart attacks later in life than men, and they often have other diseases (such as arthritis) that might mimic heart attack symptoms.
• Increased age and the more advanced stages of coronary heart disease in women can affect treatment options available to physicians.
• Traditional diagnostic tests may not be as accurate in women. The standard exercise stress test (walking on a treadmill with ECG monitoring) does not have the same predictive value in women as it does for men.