No matter what your gender, you have about 100,000 miles of blood vessels in your body— enough to circle the earth four times. And your heart pumps about 4,300 gallons of blood through those vessels each day to every single organ and other tissues in your body. The blood drops off oxygen and nutrients to all of the body’s cells, and it picks up carbon dioxide and other waste. But inside a woman, a heart has a distinctly feminine touch. Consider these differences between women and men. Warning Signs Men: Often the first sign of heart disease is a heart attack itself, a feeling like the chest is being run over by a Mack truck. Women: Women’s first warning signs are much more subtle and often hard to pinpoint. They may feel fatigue when doing something that they used to do easily, such as play tennis, run to catch a train, change sheets, or walk up two flights of stairs. Sometimes heart disease registers in women as a feeling of mild indigestion. Often there’s no chest pain whatsoever. Our Arteries Men: Men’s arteries are large compared to women’s. Women: Women’s smaller arteries make procedures like bypass surgery trickier. A bypass is a rerouting of blood from a blocked or nearly blocked blood vessel to a healthy one. Small vessels are harder to work worth, which may be part of the reason that, in a review of some 300,000 people undergoing bypass surgery, the death rate was higher in women than in men. Our Emotions Men: Preliminary research suggests that men with type A personalities— which go hand in hand with hostility, cynicism, and impatience— are more likely than other men to die after a heart attack. Women: Women seem more likely to die after a heart attack if they repress anger and react without agitation to stressful events. Social Behavior Men: Research has not generally linked social isolation to heart attacks in males. Women: Research on non-human primates suggests that social isolation and limited freedom of movement boosts heart disease among females. Furthermore, female monkeys housed alone have more extensive hardening of the arteries than female monkeys housed in social groups. We women need each other to keep our hearts in good shape. Taking Women More Seriously • Women undergo intensive treatment for heart disease much less often than men with symptoms that are just as severe. • Women’s more vague heart disease symptoms continue to be overlooked. In one study, women under 55 were seven times more likely than any other group not to be hospitalized from the emergency room when they were suffering from a type of heart problem called acute angina. • Women who have had a heart attack are less likely than male heart attack patients to undergo a procedure known as cardiac catheterization, which analyzes blood flow in the arteries leading to the heart to assess the exact location and degree of damage. • Women are much less likely than men to undergo a standard treadmill test, which helps pinpoint heart disease risk. That’s true even though it has been found that a woman’s results on a standardized treadmill test might be more predictive of whether she’ll die than a man. Tending to Our Hearts • Women often downplay red flags such as persistent fatigue, ongoing indigestion, and the like. They misinterpret their own vague symptoms, assuming that their hearts are immune to trouble. • Women wait longer than men to get to the hospital when they’re having a heart attack. More muscle has died by the time they receive treatment. • If you’re not feeling yourself, get to the doctor’s office. Women often have a month or more between not feeling up-to-snuff and the onset of a heart attack. Men typically don’t have that window of opportunity.