Table of ContentsView AllTable of ContentsSigns in WomenChest Pain in WomenOther Chest Pain CausesWhen to See a ProviderDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Signs in Women
Chest Pain in Women
Other Chest Pain Causes
When to See a Provider
Diagnosis
Treatment
Chest pain may indicate a heart attack in women and men but have other possible causes, including heart inflammation, a lung infection or blood clot, heartburn, rib fracture, or a painful condition like fibromyalgia.
Pinpointing the cause of chest pain and whether it stems from a heart attack or other life-threatening conditions like a blood clot is paramount to preventing complications such as heart failure or even death.
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A Note on Sex and Gender TerminologyVerywell Health acknowledges thatsex and genderare related but different concepts. To accurately reflect our sources, this article uses terms like “women” to describe people identified as females at birth based on their anatomic, chromosomal, and hormonal biology rather than gender identity. Likewise, “men” describes people identified as males at birth.
A Note on Sex and Gender Terminology
Verywell Health acknowledges thatsex and genderare related but different concepts. To accurately reflect our sources, this article uses terms like “women” to describe people identified as females at birth based on their anatomic, chromosomal, and hormonal biology rather than gender identity. Likewise, “men” describes people identified as males at birth.
Signs of a Heart Attack in Women
Most heart attacks develop fromcoronary artery disease, in which fatty clumps (plaque) accumulate within thecoronary arteries, which normally feed the heart with oxygenated blood.
The plaques can break open, forming a blood clot that can partially or completely block the inside of a coronary artery, causing a heart attack due to insufficient blood flow.
The most common initial symptom of a heart attack in women (and men) is substernal (underneath the breastplate) or left-sidedchest painthat can travel (radiate) to the neck or jaw.
The most common presentation of heart attack is crushing, pressure-like tightness in both men and women.
Moreover, even though chest pain is still the most common initial symptom of a heart attack in both women and men, a heart attack in the absence of chest pain is more likely to happen in women.
Other possiblesymptoms and signs of a heart attack in womeninclude:
Seek Emergency Care for Heart Attack SymptomsIf you think you or someone you are with is having a heart attack, call 911 or go to the emergency room immediately. Do not ignore the symptoms.
Seek Emergency Care for Heart Attack Symptoms
If you think you or someone you are with is having a heart attack, call 911 or go to the emergency room immediately. Do not ignore the symptoms.
Is Chest Pain in Women Different Than in Men?
As evidenced above, when it comes to chest pain from a heart attack, there are more similarities in presentation than differences between men and women.
Nevertheless, one 2018 study that retroactively analyzed nearly 1,000 women and over 3,000 men with a heart attack found that women waited for an estimated 37 minutes longer than men before seeking medical attention.
For unclear reasons, according to the study, women may be less likely to attribute their symptoms to a heart attack and/or seek care.
What Is a Silent Heart Attack?
Other Causes of Chest Pain in Women
Heart-Related Conditions
Examples of heart-related causes of chest pain other than angina include the following:
Stress Cardiomyopathy
Stress cardiomyopathy, also calledtakotsubo cardiomyopathyor broken heart syndrome, causes sudden, intense chest pain similar to that of a heart attack.
The condition is thought to be a response to significant emotional or psychological distress, causing the body to release toxic levels ofcatecholamines. These hormones enlarge the heart and temporarily impair the heart’s functioning.
Postmenopausal women are most likely to develop this condition. Since stress cardiomyopathy so closely resembles a heart attack, it’s only diagnosed once a heart attack is entirely ruled out.
Pericarditis
Pericarditisis inflammation of thepericardium, the sac encompassing the heart. The hallmark symptom is sharp or stabbing chest pain that worsens when taking a deep breath or when lying down.
Anelectrocardiogram(ECG or EKG) measures the heart’s electrical activity and reveals characteristic findings in pericarditis, helping to distinguish it from a heart attack.
Gastrointestinal Conditions
Examples of conditions affecting the digestive tract that may cause chest pain include the following.
Gastroesophageal Reflux Disease (GERD)
GERDoccurs when stomach acid backs into theesophagus(the tube that carries food from the mouth to the stomach). It classically causes substernal squeezing or burning chest pain that may travel to the back, neck, jaw, or arms.
The pain—termedheartburn—typically occurs after eating and can awaken people from their sleep. Regurgitation is common; other possible symptoms include trouble swallowing (dysphagia) and cough.
GERD diagnosis is usually based on a person’s reported symptoms. However, agastroenterologist(a specialist in digestive system disorders) may perform an esophageal pH study, which measures the acidity of the esophagus, to confirm it.
Esophagitis
Esophagitisis inflammation of the esophagus. It may cause sudden pain behind the breast bone and difficulty swallowing. Causes include:
Anupper endoscopyis used to diagnose esophagitis. During this outpatient procedure, the provider uses a thin, flexible tube with a tiny camera to look for signs of inflammation inside the esophagus.
Lung-Related Conditions
Examples of lung conditions that may cause chest pain include the following:
Pneumonia
Pneumoniais a lung infection that can cause chest pain, usually described as sharp and worsens with breathing (pleuritic chest pain). Other common symptoms include fever or chills, cough, shortness of breath, and feeling unwell (malaise).
Pneumonia is diagnosed with achest X-ray. Factors that increase a person’s risk for pneumonia include older age and underlying heart or lung disease, likecongestive heart failureorchronic obstructive pulmonary disease(COPD).
Pulmonary Embolism
Apulmonary embolism(PE) occurs when a blood clot lodges within the lungs. Most often, the blood clot forms in a deep vein in the leg (deep vein thrombosis, or DVT) before breaking off and moving through the bloodstream to the lungs.
Achest computed tomographyangiography (CTA)—a special X-ray imaging test that uses contrast dye to look for blocked blood vessels in the lungs—diagnoses PE.
Major risk factors for a blood clot include active cancer, late pregnancy, recent surgery, or limited mobility. Moderate risk factors includehormone replacement therapy,oral contraception, prolonged travel in the sitting position, or having obesity.
Bone or Muscle Problems
Examples of musculoskeletal conditions that may cause chest pain include the following.
Costochondritis
Costochondritisis inflammation of the cartilage where your ribs connect to your breastbone. The pain may be described as dull, aching, sharp, or stabbing and often worsens when you take a deep breath, make arm movements, or engage in physical activity.
Costochondritis is diagnosed based on medical history and a physical exam. The affected areas of cartilage often show tenderness.
Fibromyalgia
Chest pain or tenderness may occur in 8% to 71% of affected individuals and, if present, is usually near the edges of the breastbone, potentially suggesting overlapping costochondritis.
Fibromyalgia Chest Pain
Rib Fracture
Arib fracturemay occur due to trauma orosteoporosis, a condition of bone thinning and weakening that makes bones prone to fracture (breaking). It can be diagnosed through a physical exam and a chest X-ray.
Osteoporosis is 4 times more common in women than in men.Postmenopausal women are particularly at risk for osteoporosis due to low estrogen levels and advancing age.
Other risk factors include low body weight, cigarette smoking, excess alcohol consumption, and prolonged steroid use.
Other Causes of Chest PainWhile not a complete list, other causes of chest pain include:Aortic dissectionis a life-threatening tear in the inner lining of the body’s main artery, causing sudden and severe chest or upper back pain.Heart failureis when the heart malfunctions and cannot effectively pump enough blood throughout the body.Aortic stenosisis when one of the four valves in the heart is narrowed, making the heart work harder to pump oxygenated blood to the rest of the body.Peptic ulcer diseasedescribes open sores in the stomach lining or small intestines.Pneumothoraxoccurs when air seeps out of the lung, causing the lung to collapse.Shingles, also called herpes zoster, is a painful blistering rash that may appear on the chest.Panic disorderis associated with panic attacks, episodes of intense and sudden fear, and anxiety.
Other Causes of Chest Pain
While not a complete list, other causes of chest pain include:Aortic dissectionis a life-threatening tear in the inner lining of the body’s main artery, causing sudden and severe chest or upper back pain.Heart failureis when the heart malfunctions and cannot effectively pump enough blood throughout the body.Aortic stenosisis when one of the four valves in the heart is narrowed, making the heart work harder to pump oxygenated blood to the rest of the body.Peptic ulcer diseasedescribes open sores in the stomach lining or small intestines.Pneumothoraxoccurs when air seeps out of the lung, causing the lung to collapse.Shingles, also called herpes zoster, is a painful blistering rash that may appear on the chest.Panic disorderis associated with panic attacks, episodes of intense and sudden fear, and anxiety.
While not a complete list, other causes of chest pain include:
When to Contact a Healthcare Provider
If you or a loved one is experiencing symptoms of a heart attack, even if you feel “off” or have a gut instinct, call 911 right away or go to your nearest emergency room.
Also, contact your healthcare provider or seek immediate care if you are being treated for a condition associated with chest pain that worsens or feels different or if you are developing new symptoms like breathing problems, heart palpitations, or cough.
How Is Chest Pain in Women Diagnosed?
Just as with men, an ECG is nearly always the first test ordered in a woman with chest pain. Abnormal patterns on the ECG can identify a heart attack and provide clues about other heart or lung conditions.
Other parts of the diagnostic workup for chest pain include takingvital signs(temperature, heart rate, blood pressure, breathing rate) and performing a physical exam to check for abnormal heart and breath sounds, chest wall tenderness, or a skin rash.
Imaging tests or procedures that may be performed include:
Lastly, various blood tests can help sort out a chest pain diagnosis. Such tests include:
What Are the Treatment Options?
Treatment options depend on the underlying cause of the chest pain but are generally the same for people of any sex.
Keep in mind—while not every person having chest pain is having a heart attack, treatment for a heart attack may be initiated until the precise cause of the pain is determined.
Heart Attack
Treatment for a heart attack may include:
Next, various procedures are immediately performed to unblock the artery and restore blood flow. Such procedures include:
What Is a CABG?This operation involves harvesting healthy blood vessels from other body areas (e.g., legs or arms) and surgically connecting them to the blocked arteries to reroute blood flow.
What Is a CABG?
This operation involves harvesting healthy blood vessels from other body areas (e.g., legs or arms) and surgically connecting them to the blocked arteries to reroute blood flow.
Medications are also given during and right after a heart attack to help prevent more heart damage. Such medications include:
Other Causes
An overview of potential treatments for other causes of chest pain include:
Summary
Besides a heart attack, there are many other causes of chest pain, including heart inflammation (pericarditis), a blood clot in the lung (pulmonary embolism), lung infection (pneumonia), heartburn, or rib cartilage inflammation (costochondritis).
Diagnosing chest pain often starts with an electrocardiogram (ECG or EKG), which can reveal characteristic findings of a heart attack and some other conditions like pericarditis.
Depending on the provider’s underlying suspicions and the person’s associated symptoms, imaging and blood tests (e.g., chest X-ray or blood markers of heart damage) may also be performed.
The treatment of chest pain depends on the underlying cause. For example, with a heart attack, interventions to restore blood flow to the heart are performed immediately. Medications are given during and after the attack to help prevent future blockages.
If you think you or someone else might be having a heart attack, call 911 right away. Listen to your instincts and be proactive—prompt care can be lifesaving.
27 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Rubini Gimenez M, Reiter M, Twerenbold R, et al.Sex-specific chest pain characteristics in the early diagnosis of acute myocardial infarction.JAMA Intern Med. 2014;174(2):241-9. doi:10.1001/jamainternmed.2013.12199Pagidipati N, Douglas PS.Clinical features and diagnosis of coronary heart artery disease in women.In:UpToDate, Kaski JC, Pellikka PA (Eds), UpToDate, Waltham, MAHemal K, Pagidipati NJ, Coles A, et al.Sex differences in demographics, risk factors, presentation, and noninvasive testing in stable outpatients with suspected coronary artery disease: insights from the PROMISE trial.JACC Cardiovasc Imaging. 2016;9(4):337-46. doi:10.1016/j.jcmg.2016.02.001American Heart Association.Heart attack symptoms in women.Meyer MR, Bernheim AM, Kurz DJ, et al.Gender differences in patient and system delay for primary percutaneous coronary intervention: current trends in a Swiss ST-segment elevation myocardial infarction population.Eur Heart J Acute Cardiovasc Care. 2019;8(3):283-290. doi:10.1177/2048872618810410Patel H.Outpatient evaluation of the adult with chest pain. In:UpToDate, Aronson MD (Ed), UpToDate, Waltham, MAAmin HZ, Amin LZ, Pradipta A.Takotsubo cardiomyopathy: a brief review.J Med Life. 2020;13(1):3-7. doi:10.25122/jml-2018-0067Snyder MJ, Bepko J, White M.Acute pericarditis: diagnosis and management.Am Fam Physician. 2014;89(7):553-560.Maret-Ouda J, Markar SR, Lagergren J.Gastroesophageal reflux disease: a review.JAMA.2020;324(24):2536–2547. doi:10.1001/jama.2020.21360Grossi L, Ciccaglione AF, Marzio L.Esophagitis and its causes: Who is “guilty” when acid is found “not guilty”?World J Gastroenterol. 2017;23(17):3011-3016. doi:10.3748/wjg.v23.i17.3011Kaysin A, Viera AJ.Community-acquired pneumonia in adults: diagnosis and management.Am Fam Physician. 2016;94(9):698-706Bĕlohlávek J, Dytrych V, Linhart A.Pulmonary embolism, part I: epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism.Exp Clin Cardiol. 2013;18(2):129-38. allowing this slightly older reference.Barranco-Trabi J, Mank V, Roberts J, Newman DP.Atypical costochondritis: complete resolution of symptoms after rib manipulation and soft tissue mobilization.Cureus. 2021;13(4):e14369. doi:10.7759/cureus.14369Wise CM, Fenton J.Major causes of musculoskeletal chest pain in adults. In:UpToDate, Elmore JG, Goldenberg DL (Eds), UpToDate, Waltham, MAAlswat KA.Gender Disparities in Osteoporosis.J Clin Med Res. 2017 May;9(5):382-387. doi:10.14740/jocmr2970wJi MX, Yu Q.Primary osteoporosis in postmenopausal women.Chronic Dis Transl Med. 2015;1(1):9-13. doi:10.1016/j.cdtm.2015.02.006MedlinePlus.Aortic dissection.American Heart Association.Aortic stenosis.Zarogoulidis P, Kioumis I, Pitsiou G, et al.Pneumothorax: from definition to diagnosis and treatment.J Thorac Dis. 2014;6(Suppl 4):S372-6. doi:10.3978/j.issn.2072-1439.2014.09.24Centers for Disease Control and Prevention.About shingles (herpes zoster).National Institute of Mental Health.Panic disorder: when fear overwhelms.National Heart, Lung, and Blood Institute.Heart attack.American Heart Association.Cardiac medications.Han X, Zhang Y, Yin L, et al.Statin in the treatment of patients with myocardial infarction: a meta-analysis.Medicine (Baltimore). 2018;97(12):e0167. doi:10.1097/MD.0000000000010167Lazaros G, Antonopoulos AS, Vlachopoulos C, et al.Predictors of switching from nonsteroidal anti-inflammatory drugs to corticosteroids in patients with acute pericarditis and impact on clinical outcome.Hellenic J Cardiol. 2019;60(6):357-363. doi:10.1016/j.hjc.2018.04.001American Society for Gastrointestinal Endoscopy.Understanding gastroesophageal reflux disease.Rivera-Lebron B, McDaniel M, Ahrar K, et al.Diagnosis, treatment and follow up of acute pulmonary embolism: consensus practice from the PERT Consortium.Clin Appl Thromb Hemost. 2019;25:1076029619853037. doi:10.1177/1076029619853037
27 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Rubini Gimenez M, Reiter M, Twerenbold R, et al.Sex-specific chest pain characteristics in the early diagnosis of acute myocardial infarction.JAMA Intern Med. 2014;174(2):241-9. doi:10.1001/jamainternmed.2013.12199Pagidipati N, Douglas PS.Clinical features and diagnosis of coronary heart artery disease in women.In:UpToDate, Kaski JC, Pellikka PA (Eds), UpToDate, Waltham, MAHemal K, Pagidipati NJ, Coles A, et al.Sex differences in demographics, risk factors, presentation, and noninvasive testing in stable outpatients with suspected coronary artery disease: insights from the PROMISE trial.JACC Cardiovasc Imaging. 2016;9(4):337-46. doi:10.1016/j.jcmg.2016.02.001American Heart Association.Heart attack symptoms in women.Meyer MR, Bernheim AM, Kurz DJ, et al.Gender differences in patient and system delay for primary percutaneous coronary intervention: current trends in a Swiss ST-segment elevation myocardial infarction population.Eur Heart J Acute Cardiovasc Care. 2019;8(3):283-290. doi:10.1177/2048872618810410Patel H.Outpatient evaluation of the adult with chest pain. In:UpToDate, Aronson MD (Ed), UpToDate, Waltham, MAAmin HZ, Amin LZ, Pradipta A.Takotsubo cardiomyopathy: a brief review.J Med Life. 2020;13(1):3-7. doi:10.25122/jml-2018-0067Snyder MJ, Bepko J, White M.Acute pericarditis: diagnosis and management.Am Fam Physician. 2014;89(7):553-560.Maret-Ouda J, Markar SR, Lagergren J.Gastroesophageal reflux disease: a review.JAMA.2020;324(24):2536–2547. doi:10.1001/jama.2020.21360Grossi L, Ciccaglione AF, Marzio L.Esophagitis and its causes: Who is “guilty” when acid is found “not guilty”?World J Gastroenterol. 2017;23(17):3011-3016. doi:10.3748/wjg.v23.i17.3011Kaysin A, Viera AJ.Community-acquired pneumonia in adults: diagnosis and management.Am Fam Physician. 2016;94(9):698-706Bĕlohlávek J, Dytrych V, Linhart A.Pulmonary embolism, part I: epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism.Exp Clin Cardiol. 2013;18(2):129-38. allowing this slightly older reference.Barranco-Trabi J, Mank V, Roberts J, Newman DP.Atypical costochondritis: complete resolution of symptoms after rib manipulation and soft tissue mobilization.Cureus. 2021;13(4):e14369. doi:10.7759/cureus.14369Wise CM, Fenton J.Major causes of musculoskeletal chest pain in adults. In:UpToDate, Elmore JG, Goldenberg DL (Eds), UpToDate, Waltham, MAAlswat KA.Gender Disparities in Osteoporosis.J Clin Med Res. 2017 May;9(5):382-387. doi:10.14740/jocmr2970wJi MX, Yu Q.Primary osteoporosis in postmenopausal women.Chronic Dis Transl Med. 2015;1(1):9-13. doi:10.1016/j.cdtm.2015.02.006MedlinePlus.Aortic dissection.American Heart Association.Aortic stenosis.Zarogoulidis P, Kioumis I, Pitsiou G, et al.Pneumothorax: from definition to diagnosis and treatment.J Thorac Dis. 2014;6(Suppl 4):S372-6. doi:10.3978/j.issn.2072-1439.2014.09.24Centers for Disease Control and Prevention.About shingles (herpes zoster).National Institute of Mental Health.Panic disorder: when fear overwhelms.National Heart, Lung, and Blood Institute.Heart attack.American Heart Association.Cardiac medications.Han X, Zhang Y, Yin L, et al.Statin in the treatment of patients with myocardial infarction: a meta-analysis.Medicine (Baltimore). 2018;97(12):e0167. doi:10.1097/MD.0000000000010167Lazaros G, Antonopoulos AS, Vlachopoulos C, et al.Predictors of switching from nonsteroidal anti-inflammatory drugs to corticosteroids in patients with acute pericarditis and impact on clinical outcome.Hellenic J Cardiol. 2019;60(6):357-363. doi:10.1016/j.hjc.2018.04.001American Society for Gastrointestinal Endoscopy.Understanding gastroesophageal reflux disease.Rivera-Lebron B, McDaniel M, Ahrar K, et al.Diagnosis, treatment and follow up of acute pulmonary embolism: consensus practice from the PERT Consortium.Clin Appl Thromb Hemost. 2019;25:1076029619853037. doi:10.1177/1076029619853037
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Rubini Gimenez M, Reiter M, Twerenbold R, et al.Sex-specific chest pain characteristics in the early diagnosis of acute myocardial infarction.JAMA Intern Med. 2014;174(2):241-9. doi:10.1001/jamainternmed.2013.12199Pagidipati N, Douglas PS.Clinical features and diagnosis of coronary heart artery disease in women.In:UpToDate, Kaski JC, Pellikka PA (Eds), UpToDate, Waltham, MAHemal K, Pagidipati NJ, Coles A, et al.Sex differences in demographics, risk factors, presentation, and noninvasive testing in stable outpatients with suspected coronary artery disease: insights from the PROMISE trial.JACC Cardiovasc Imaging. 2016;9(4):337-46. doi:10.1016/j.jcmg.2016.02.001American Heart Association.Heart attack symptoms in women.Meyer MR, Bernheim AM, Kurz DJ, et al.Gender differences in patient and system delay for primary percutaneous coronary intervention: current trends in a Swiss ST-segment elevation myocardial infarction population.Eur Heart J Acute Cardiovasc Care. 2019;8(3):283-290. doi:10.1177/2048872618810410Patel H.Outpatient evaluation of the adult with chest pain. In:UpToDate, Aronson MD (Ed), UpToDate, Waltham, MAAmin HZ, Amin LZ, Pradipta A.Takotsubo cardiomyopathy: a brief review.J Med Life. 2020;13(1):3-7. doi:10.25122/jml-2018-0067Snyder MJ, Bepko J, White M.Acute pericarditis: diagnosis and management.Am Fam Physician. 2014;89(7):553-560.Maret-Ouda J, Markar SR, Lagergren J.Gastroesophageal reflux disease: a review.JAMA.2020;324(24):2536–2547. doi:10.1001/jama.2020.21360Grossi L, Ciccaglione AF, Marzio L.Esophagitis and its causes: Who is “guilty” when acid is found “not guilty”?World J Gastroenterol. 2017;23(17):3011-3016. doi:10.3748/wjg.v23.i17.3011Kaysin A, Viera AJ.Community-acquired pneumonia in adults: diagnosis and management.Am Fam Physician. 2016;94(9):698-706Bĕlohlávek J, Dytrych V, Linhart A.Pulmonary embolism, part I: epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism.Exp Clin Cardiol. 2013;18(2):129-38. allowing this slightly older reference.Barranco-Trabi J, Mank V, Roberts J, Newman DP.Atypical costochondritis: complete resolution of symptoms after rib manipulation and soft tissue mobilization.Cureus. 2021;13(4):e14369. doi:10.7759/cureus.14369Wise CM, Fenton J.Major causes of musculoskeletal chest pain in adults. In:UpToDate, Elmore JG, Goldenberg DL (Eds), UpToDate, Waltham, MAAlswat KA.Gender Disparities in Osteoporosis.J Clin Med Res. 2017 May;9(5):382-387. doi:10.14740/jocmr2970wJi MX, Yu Q.Primary osteoporosis in postmenopausal women.Chronic Dis Transl Med. 2015;1(1):9-13. doi:10.1016/j.cdtm.2015.02.006MedlinePlus.Aortic dissection.American Heart Association.Aortic stenosis.Zarogoulidis P, Kioumis I, Pitsiou G, et al.Pneumothorax: from definition to diagnosis and treatment.J Thorac Dis. 2014;6(Suppl 4):S372-6. doi:10.3978/j.issn.2072-1439.2014.09.24Centers for Disease Control and Prevention.About shingles (herpes zoster).National Institute of Mental Health.Panic disorder: when fear overwhelms.National Heart, Lung, and Blood Institute.Heart attack.American Heart Association.Cardiac medications.Han X, Zhang Y, Yin L, et al.Statin in the treatment of patients with myocardial infarction: a meta-analysis.Medicine (Baltimore). 2018;97(12):e0167. doi:10.1097/MD.0000000000010167Lazaros G, Antonopoulos AS, Vlachopoulos C, et al.Predictors of switching from nonsteroidal anti-inflammatory drugs to corticosteroids in patients with acute pericarditis and impact on clinical outcome.Hellenic J Cardiol. 2019;60(6):357-363. doi:10.1016/j.hjc.2018.04.001American Society for Gastrointestinal Endoscopy.Understanding gastroesophageal reflux disease.Rivera-Lebron B, McDaniel M, Ahrar K, et al.Diagnosis, treatment and follow up of acute pulmonary embolism: consensus practice from the PERT Consortium.Clin Appl Thromb Hemost. 2019;25:1076029619853037. doi:10.1177/1076029619853037
Rubini Gimenez M, Reiter M, Twerenbold R, et al.Sex-specific chest pain characteristics in the early diagnosis of acute myocardial infarction.JAMA Intern Med. 2014;174(2):241-9. doi:10.1001/jamainternmed.2013.12199
Pagidipati N, Douglas PS.Clinical features and diagnosis of coronary heart artery disease in women.In:UpToDate, Kaski JC, Pellikka PA (Eds), UpToDate, Waltham, MA
Hemal K, Pagidipati NJ, Coles A, et al.Sex differences in demographics, risk factors, presentation, and noninvasive testing in stable outpatients with suspected coronary artery disease: insights from the PROMISE trial.JACC Cardiovasc Imaging. 2016;9(4):337-46. doi:10.1016/j.jcmg.2016.02.001
American Heart Association.Heart attack symptoms in women.
Meyer MR, Bernheim AM, Kurz DJ, et al.Gender differences in patient and system delay for primary percutaneous coronary intervention: current trends in a Swiss ST-segment elevation myocardial infarction population.Eur Heart J Acute Cardiovasc Care. 2019;8(3):283-290. doi:10.1177/2048872618810410
Patel H.Outpatient evaluation of the adult with chest pain. In:UpToDate, Aronson MD (Ed), UpToDate, Waltham, MA
Amin HZ, Amin LZ, Pradipta A.Takotsubo cardiomyopathy: a brief review.J Med Life. 2020;13(1):3-7. doi:10.25122/jml-2018-0067
Snyder MJ, Bepko J, White M.Acute pericarditis: diagnosis and management.Am Fam Physician. 2014;89(7):553-560.
Maret-Ouda J, Markar SR, Lagergren J.Gastroesophageal reflux disease: a review.JAMA.2020;324(24):2536–2547. doi:10.1001/jama.2020.21360
Grossi L, Ciccaglione AF, Marzio L.Esophagitis and its causes: Who is “guilty” when acid is found “not guilty”?World J Gastroenterol. 2017;23(17):3011-3016. doi:10.3748/wjg.v23.i17.3011
Kaysin A, Viera AJ.Community-acquired pneumonia in adults: diagnosis and management.Am Fam Physician. 2016;94(9):698-706
Bĕlohlávek J, Dytrych V, Linhart A.Pulmonary embolism, part I: epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism.Exp Clin Cardiol. 2013;18(2):129-38. allowing this slightly older reference.
Barranco-Trabi J, Mank V, Roberts J, Newman DP.Atypical costochondritis: complete resolution of symptoms after rib manipulation and soft tissue mobilization.Cureus. 2021;13(4):e14369. doi:10.7759/cureus.14369
Wise CM, Fenton J.Major causes of musculoskeletal chest pain in adults. In:UpToDate, Elmore JG, Goldenberg DL (Eds), UpToDate, Waltham, MA
Alswat KA.Gender Disparities in Osteoporosis.J Clin Med Res. 2017 May;9(5):382-387. doi:10.14740/jocmr2970w
Ji MX, Yu Q.Primary osteoporosis in postmenopausal women.Chronic Dis Transl Med. 2015;1(1):9-13. doi:10.1016/j.cdtm.2015.02.006
MedlinePlus.Aortic dissection.
American Heart Association.Aortic stenosis.
Zarogoulidis P, Kioumis I, Pitsiou G, et al.Pneumothorax: from definition to diagnosis and treatment.J Thorac Dis. 2014;6(Suppl 4):S372-6. doi:10.3978/j.issn.2072-1439.2014.09.24
Centers for Disease Control and Prevention.About shingles (herpes zoster).
National Institute of Mental Health.Panic disorder: when fear overwhelms.
National Heart, Lung, and Blood Institute.Heart attack.
American Heart Association.Cardiac medications.
Han X, Zhang Y, Yin L, et al.Statin in the treatment of patients with myocardial infarction: a meta-analysis.Medicine (Baltimore). 2018;97(12):e0167. doi:10.1097/MD.0000000000010167
Lazaros G, Antonopoulos AS, Vlachopoulos C, et al.Predictors of switching from nonsteroidal anti-inflammatory drugs to corticosteroids in patients with acute pericarditis and impact on clinical outcome.Hellenic J Cardiol. 2019;60(6):357-363. doi:10.1016/j.hjc.2018.04.001
American Society for Gastrointestinal Endoscopy.Understanding gastroesophageal reflux disease.
Rivera-Lebron B, McDaniel M, Ahrar K, et al.Diagnosis, treatment and follow up of acute pulmonary embolism: consensus practice from the PERT Consortium.Clin Appl Thromb Hemost. 2019;25:1076029619853037. doi:10.1177/1076029619853037
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