Several studies document that women are more likely than men to present with chest pain rather than a definite event like a heart attack as either the first or subsequent expression of coronary artery disease (CAD). Compared to men, women with chest pain are older by about 10 years and are more likely to have high blood pressure, diabetes or congestive heart failure but are less likely to have had a prior heart attack or procedure on their coronary arteries. Although equally likely to have effort induced chest pain, women are more likely to experience chest pain at rest, during sleep that awakens them, or with mental stress. In women who do experience a heart attack, they are more likely to have nausea and jaw, back or neck pain or palpitations and are less likely to have diaphoresis than men. The reasons for these differences are unclear.
Women are, however, more likely to have vasospastic or small vessel causes of chest pain both of which are associated with atypical chest pain, are often treated differently, and have a more favorable outcome than chest pain from CAD. Finally, women not uncommonly have non-CAD chest pain syndromes that complicate the assessment of the chest pain pattern. On a positive note, women with chest pain are less likely to experience a heart attack or coronary death than men.
As always, please consult your primary care physician to identify the best prevention and treatment options that are right for you.