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Women’s hearts beat differently!
Heart disease in women is different from in men – and AI makes this visible!

Cardiovascular diseases are the leading cause of death in Germany. For women in particular, they represent a silent and often underestimated danger. Women are not only diagnosed later, but also receive guideline-based treatment less frequently – and have a higher in-hospital mortality rate than men. [1]

One reason for this is that heart problems in women are often overlooked. While chest pain is considered a classic warning sign in men, symptoms in women are often much more subtle. Sleep disturbances, exhaustion, or inner restlessness are typical indicators, but they are often dismissed in everyday life – both by the women themselves and by healthcare professionals. When women report symptoms, they more frequently describe upper abdominal or back pain, shortness of breath, or nausea.

 

1. Different symptoms

  • Men often show the “classic” symptoms of a heart attack: severe chest pain, a feeling of pressure, pain radiating to the left arm.
  • Women more frequently experience atypical symptoms such as nausea, vomiting, upper abdominal or back pain, shortness of breath, fatigue, or dizziness. These symptoms are often not immediately associated with the heart.

2. Medical–historical reasons

  • For many years, most cardiology studies were conducted primarily on men.
  • As a result, diagnostics, thresholds and guidelines are often based on male patterns.

3. Misinterpretations in everyday practice

  • Women’s symptoms are sometimes dismissed by physicians as psychosomatic or as stress-related.
    Women themselves tend to underestimate their symptoms or delay seeking help.

4. Biological differences

  • Women have smaller coronary arteries, which can make diagnosing blockages more difficult.
    They often develop heart disease later in life (after menopause the risk increases significantly because the protective effect of estrogen decreases).

 

Symptom Type: Chest

  • Typical Symptoms Severe, persistent chest pain or pressure
  • Atypical / More Common in Women: Mild pressure, tightness, burning; brief or fluctuating

Symptom Type: Arms / Shoulder / Back / Neck / Jaw

  • Typical Symptoms Pain in left arm or shoulder
  • Atypical / More Common in Women: Pain in both arms, shoulder blade, neck, upper abdomen, jaw

Symptom Type: Respiratory

  • Typical Symptoms Shortness of breath during exertion
  • Atypical / More Common in Women: Sudden shortness of breath at rest; breathlessness without chest pain

Symptom Type: Stomach / Digestion

  • Typical Symptoms –
  • Atypical / More Common in Women: Nausea, vomiting, heartburn-like sensations, feeling of fullness

Symptom Type: Sweating

  • Typical Symptoms Cold sweats during pain peaks
  • Atypical / More Common in Women: Sudden, intense sweating without typical chest symptoms

Symptom Type: General / Psychological

  • Typical Symptoms Anxiety, panic
  • Atypical / More Common in Women: Unusual fatigue, exhaustion, dizziness, lightheadedness

Symptom Type: Rare

  • Typical Symptoms –
  • Atypical / More Common in Women: Back pain, weakness, disorientation

 

A new study conducted with MEDIACC shows that artificial intelligence can help break this invisibility.[2]

Key findings:

  • Superior to standard tools: While conventional scores like the CVRF score simply add up risk factors, the CSG Index “sees” patterns hidden within the data.
  • Especially better in women: In the study, the CSG Index performed significantly better for women.
  • Making the invisible visible: Particularly remarkable was its ability to detect early disease in symptom-free women. This means that even without symptoms, heart weakness or vascular alterations could be predicted.

This is especially the case when a conventional ECG appears normal. Cardisiography showed superior accuracy in detecting cardiovascular risk, particularly in asymptomatic women.

 

What is included in a Cardisiography report:

  • Ischemia Index (CSG Ischemia Index / “P”)
  • Structural Heart Disease Index (CSG-SHD / “S”)
  • Arrhythmia Index (A)

Additionally: selected VCG parameters (QRS-T angle, QRS duration, T-wave metrics), a 12-lead ECG view plus extended leads: extended left-sided leads V7–V9 and right-sided leads Vr3–Vr6 (ESC guideline recommendation from 2023), and vector loops.

More advanced technologies in this field, such as CT or MRI, are too complex and too expensive to use prophylactically. Cardisiography was specifically developed as a decision-support tool for the early diagnostic phase, to detect heart diseases that do not appear in conventional ECG examinations.

 

Cardisiographs comply with the standards and regulations according to EN 55032:2015 Class B, EN55024:2010+A1:2015, 47 CFR Part 15.

 

What Women Can Do

  1. Take your own symptoms seriously — even if they seem “unusual.”
  2. Seek medical help early — it’s better to call emergency services (112) once too often than too late.
  3. Know and control your risk factors:
    • High blood pressure
    • Diabetes
    • Smoking
    • Lack of physical activity
    • Overweight
    • Family history
  4. Have regular check-ups with your GP/cardiologist (blood pressure, blood lipids, ECG).
  5. Maintain a healthy lifestyle: physical activity, balanced diet, stress reduction.

Reminder: If you feel unusual, sudden, or severe symptoms that you cannot explain → call emergency services 112 ! Better a “false alarm” than acting too late.

 

1. https://herzmedizin.de/fuer-patienten-und-interessierte/aktuelles/news/todesursachenstatistik-2023-destatis-herz-kreislauf-erkrankungen.html
2. https://herzmedizin.de/fuer-aerzte-und-fachpersonal/kongresse/dgk-herztage-2024/programm/diagnostik__von_konventionell_zu_ki/v537.html

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