February 2, 2007 - The 'Harvard Women's Health Watch' (February 2007) published results of the Women's Ischemia Syndrome Evaluation (WISE) study suggesting that many women with heart disease don't get a proper diagnosis because they have a form of the disease that doesn't show up on the usual diagnostic tests. The new research shows that heart disease is not one but several disorders and may shed light on why heart disease often behaves differently in men and women.
In the study, women with chronic chest pain underwent standard diagnostic procedures, including stress tests and coronary angiograms. As with earlier studies showing women are far more likely than men to appear free of blockages on follow-up angiograms, the findings were similar in the WISE study. But newer tests, including ultrasound of the blood vessels, revealed heart problems the angiograms didn't pick up. Many of these women had a condition called vascular dysfunction, in which the blood vessels supplying the heart don't expand properly to accommodate increased blood flow and may affect large coronary arteries and smaller vessels that serve the heart, a condition known as microvessel disease. Women with heart disease are often under diagnosed and under treated because they are more likely than men to have microvessel disease that can't be seen. The WISE investigators are working to develop a new system for screening women for heart disease.
Harvard Health Publications - http://www.health.harvard.edu/women
This article also appears in Women's Health / OBGYN
November 03, 2025 
