Chest pain, shortness of breath, fatigue, swollen limbs and ankles, dizziness—when presented in certain combinations, the symptoms of heart disease can be mistaken for other illnesses. Worse still, because women’s symptoms are slightly different than men’s (sometimes the disease can manifest itself in the fairer sex through discomfort in the neck or shoulder and nausea or vomiting), they stand a greater chance of having their heart disease initially misdiagnosed.

In fact, a study released by the Cardiac Research Foundation just a few months ago found that women with coronary heart disease (CHD) were more than twice as likely as men to be told their symptoms were due to stress rather than CHD. Here’s why, as well as a couple of other ailments that are often confused with heart disease.

Anxiety attacks. According the American Psychiatric Association, the following symptoms are associated with a panic attack: a pounding heart or chest pain, shortness of breath, nausea or abdominal pain, dizziness, numbness, and chills or hot flashes. Sound familiar? The National Institute of Mental Health estimates that there are 6 million Americans who suffer from panic disorder; at least half that number suffer a panic attack every year. And a 2005 study found that people with panic disorder are twice as likely to develop heart disease, a link that researchers continue to examine. 

Asthma. With symptoms such as shortness of breath and tightness in the chest, it’s not surprising that asthma can be mistaken for heart disease. What might be eyebrow-raising for some is the idea that adults can be diagnosed with asthma too. According to the Centers for Disease Control and Prevention, about 14 million adults are told they have asthma, one of the reasons being that a consequence of aging is a diminished lung capacity. Also, adult on-set asthma has been shown to increase heart disease risk by more than 30 percent.

Gastroesophageal reflux disease (GERD). One of the key indicators of a heart attack—that excruciating pain spreading through the chest and down the arm—is also a characteristic of esophageal disease, particularly GERD. Worse still, some factors that increase the likelihood for GERD, such as a high-fat diet, obesity, and asthma, foster heart disease too. The best way to protect yourself against a misdiagnosis is to be well familiar with your body and your family’s medical history, and most important, clearly and firmly communicate any concerns you have about your diagnosis with your doctor.