I'm a cardiologist. A 42-year-old mother of two came to my office complaining of jaw pain and crushing fatigue. She ran half-marathons. Her EKG was normal. Another doctor had sent her home with anxiety medication.
When I got her into the cath lab, I found severe microvascular disease — plaque choking the tiniest vessels of her heart, the ones standard angiograms routinely miss.
Her heart had been starving in silence while everyone told her she was stressed.
She is alive today. Too many women like her are not.
Heart disease kills more women than every cancer combined. And medicine is still diagnosing it through a male lens.
84% of cardiologists report having patients in the past year whose heart disease was misdiagnosed by another physician. Women with a STEMI heart attack have a 59% greater chance of being misdiagnosed compared to men. Women with an NSTEMI — 41% greater chance.
The reason is structural. For decades, we screened, tested, and treated women using a template built for men.
Men's heart attacks announce themselves — the crushing chest pain, the clutched fist, the Hollywood collapse. Women's hearts whisper. Crushing fatigue that feels like wearing a lead vest. Jaw pain written off as TMJ. Nausea blamed on a stomach bug. An ache between the shoulder blades blamed on a long week. Shortness of breath blamed on being out of shape.
For years, medicine called these "atypical" symptoms. They are not atypical. They are female-typical. Half of humanity is not a variant.
And the biology runs deeper than symptoms.
Women have smaller hearts and narrower coronary arteries. Plaque doesn't only clog the big highway vessels — it hides in the microvasculature, the tiny branches feeding the heart muscle itself. A woman can have a heart attack with a completely "clean" standard angiogram.
SCAD — spontaneous coronary artery dissection — occurs 90% of the time in women. Often young, fit women with zero traditional risk factors. It's the leading cause of heart attack in women under 50, accounting for roughly one quarter of all cases in that age group. Most doctors have never diagnosed one.
And some of the most dangerous cardiac risk factors are hidden in women's medical histories where no one thinks to look:
Preeclampsia or gestational hypertension doubles to quadruples lifetime heart disease and stroke risk. Pregnancy is the body's first cardiac stress test — and these complications are early warning sirens, not closed chapters.
Autoimmune disease — lupus, rheumatoid arthritis, psoriasis — far more common in women, turbocharges inflammation and plaque formation at any age.
Cardiovascular disease in women aged 20-44 is projected to surge nearly 50% by 2050.
The youngest patients in my practice keep getting younger.
What every woman should ask her doctor — and what every doctor should be asking:
"Given my pregnancy history, autoimmune status, and family history — what is my full cardiovascular risk?" If they don't ask about preeclampsia or gestational diabetes, volunteer it.
"Should I have an Lp(a) test and a coronary calcium score?" Standard cholesterol panels miss too much. Lp(a) is genetic, one-time, and most women have never been tested.
"My tests came back normal but my symptoms haven't stopped — what's next?" Normal stress tests and angiograms can miss microvascular disease, spasm, and SCAD. Persistent symptoms warrant coronary CT angiography or cardiac MRI.
And if something feels wrong — say these exact words to your doctor: "I am concerned this could be my heart."
That single sentence changes the workup. Do not soften it. Do not apologize for it.
80% of heart disease is preventable. But the playbook has to be built for female biology.
Two decades ago, I wrote one of the first books warning that heart disease was the number one killer of women and that medicine was diagnosing it through a male lens. It was recognized by First Lady Laura Bush at the White House during the early years of the national conversation about women's heart health.
I'm haunted by how much of that book I could republish today unchanged.
The science has advanced. The awareness has grown. But the gap between what we know and what happens in the exam room is still costing women their lives.
Share this with every woman you love — and every doctor who treats them. READ MORE: https://t.co/4LRugiY8q2
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Abeokuta ilu Ẹ̀gbá, ọmọ Lisabi!
This is no ordinary city, it is a fortress of freedom, a granite throne where history refused to kneel. Abeokuta, the legendary “Rock City,” was born in the crucible of resistance. In the early 19th century, the fearless Egba people fled the chaos of inter-tribal wars and the fading grip of the Oyo Empire. Guided by the unyielding spirit of Lisabi Agbongbo Akala, the warrior-farmer who had already shattered Oyo’s chains decades earlier in a daring uprising, they discovered Olumo Rock and declared: “Here, under the rock, we shall rise!”
Olumo Rock is not just stone; it is a living ancestor. Towering 137 metres, riddled with sacred caves where our forebears hid, prayed, and fought, it became their shield. From its summit today, the entire city spreads out like a proud tapestry, rooftops kissing the sky, the Ogun River shimmering below. And the miracle? Since the Egba first climbed it in 1830, no one has ever fallen. That is not luck. That is covenant. That is Egba power.
Lisabi’s name still thunders through every heartbeat. We are Omo Lisabi, children of the liberator who used the ancient Aaro cooperative system to unite farmers into an unstoppable force, who struck down Oyo’s arrogant Ilaris in one coordinated blow and lit the flame of Egba independence.
Every year, the Lisabi Festival draws sons and daughters home to the sacred forest, where drums roll, rites are performed.
Abeokuta is more than memory, it is greatness personified, walk the ancient halls of the Alake’s Palace. Stand where the first church in Nigeria (St. Peter’s Cathedral) raised its voice.
Abeokuta is resilience wrapped in beauty, courage carved in rock, and destiny written in Yoruba blood. Whether you were born here or your roots simply call you home, one thing is certain: once an *Omo Lisabi*, always a child of the rock.
#OlumoRock #EgbaPride #RockCity #YorubaHeritage #LisabiFestival #UnderTheRock