Unveiling the Hidden Threat: Recognising Undiagnosed Heart Failure in Women
Cardiovascular disease is the leading cause of death in women, yet it remains too often under-recognised, under-diagnosed, and under-treated. In this important talk, Prof Alta Schutte explores how decades of male-focused research, the under-representation of women in clinical trials and limited female leadership in guideline development have contributed to gaps in care. She also highlights recent progress and calls for systemic change to ensure women receive timely and effective diagnosis and treatment.
Cardiovascular disease in women is frequently underdiagnosed, with heart failure often overlooked due to subtle symptoms and persistent clinical bias. In this on-demand symposium, leading experts explore why cardiovascular disease is missed in women, the unique risks and presentations of female heart failure and how early detection of atrial fibrillation can improve outcomes. Chaired by Prof Renate B Schnabel (University Heart Center Hamburg, Hamburg, Germany) and Prof Eva Gerdts (University of Bergen, Bergen, Norway) the session brings together international perspectives from Prof Alta Schutte (University of New South Wales, Sydney, Australia) highlighting practical strategies to promote earlier recognition, equitable care and improved prognosis for women at risk of heart failure.
Complementing this symposium and offering further perspectives, the expert insight series Clinical Clues in Cardiovascular Disease: Enhancing Detection and Patient Monitoring is also available on demand.
More from this programme
Part 1
Bias in Cardiovascular Care: Why Is Cardiovascular Disease Often Missed in Women?
Cardiovascular disease is the leading cause of death in women, yet it remains too often under-recognised, under-diagnosed, and under-treated. In this important talk, Prof Alta Schutte explores how decades of male-focused research, the under-representation of women in clinical trials and limited female leadership in guideline development have contributed to gaps in care. She also highlights recent progress and calls for systemic change to ensure women receive timely and effective diagnosis and treatment.
Part 2
Risks and Symptoms of Female Heart Failure
While lifetime risk of heart failure is similar in women and men, women are more likely to develop HFpEF and show symptoms such as nocturnal breathlessness and orthopnea – often overlooked or misattributed, delaying diagnosis. Hypertension, diabetes, and obesity carry greater risk for women, while pregnancy complications, autoimmune diseases, anaemia, and psychosocial factors add further vulnerability. Prof Eva Gerdts underscores the need to recognise these differences to improve prevention and care.
Part 3
How Early Detection of Atrial Fibrillation Can Improve Patient Outcomes
Atrial fibrillation affects one in three people, and often appears later in women. Hypertension and other risk factors drive its development and link it to stroke and heart failure. Prof Renate Schnabel shows how detecting AF earlier – through monitoring, devices, or consumer technologies – creates opportunities to manage co-morbidities, control rhythm, and reduce progression. While widespread screening is not yet recommended, timely detection can help prevent stroke, dementia, and heart failure, highlighting early diagnosis as a crucial step toward better outcomes.
Part 4
Panel Discussion and Summary
The panel examines why cardiovascular disease in women remains under-recognised, pointing to pregnancy complications, mental health, and socio-economic factors, alongside persistent academic and editorial bias. They stress that both women and healthcare providers often overlook symptoms, delaying diagnosis and treatment. Greater awareness, starting in medical education and public outreach, is essential to close these gaps.
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Faculty Biographies
Alta Schutte
Faculty of Medicine and Health at UNSW Sydney, Australia
Prof Alta Schutte is a Professor and Principal Theme Lead of Cardiac, Vascular and Metabolic Medicine in the Faculty of Medicine and Health at UNSW Sydney, Australia; with a joint appointment as Professorial Fellow at the George Institute for Global Health. Prof Schutte has extensive experience in working in clinical and population-based studies with a focus on raised blood pressure, hypertension and cardiovascular disease. She is involved in numerous international consortia, such as the Global Burden of Disease study, the NCD Risk Factor Collaboration and the May Measurement Month initiative of the International Society of Hypertension. Her expertise includes the management of hypertension and monitoring of raised blood pressure, actions and interventions to improve blood pressure control and the detection, treatment and control of hypertension.
Eva Gerdts
Chief of the Non-invasive Cardiac Imaging Unit
Prof Eva Gerdts is a Professor of Cardiology at the University of Bergen, Norway, and Chief of the Non-invasive Cardiac Imaging Unit at the Haukeland University Hospital. She has published more than 240 scientific papers in peer-reviewed journals. Prof Gerdts is a licensed specialist in internal medicine and cardiology in Norway, and graduated from the University of Bergen School of Medicine in 1981.
Prof Gerdts research focuses on hypertensive heart disease, including sex differences and comorbidities such as obesity and aortic valve stenosis. She is involved in a number of ongoing projects, including the FEMALE HEART study, the Hordaland Health Study (HUSK3), the FAT associated cardiovascular dysfunction study (FATCOR), the IDA study and the Sex Differences and Hypertension in Aortic Stenosis study. Prof Gerdts is on the Editorial Board of European Cardiology Review.
Renate Schnabel
Consultant in Cardiology
Prof Renate Schnabel is a consultant in cardiology at University Heart Centre Hamburg, Germany. She graduated from medical school in Mainz, Germany in 2002. After a research fellowship at the Framingham Heart Study, Boston University, she moved to Hamburg. She works with clinical and population cohorts and leads national and EU-funded international consortia. She is PI of the German Centre for Cardiovascular Research. Her research interest is in digital cardiology, atrial fibrillation and heart failure, and cardiovascular risk assessment. Very active within professional organisations, she is a member of councils of the European Society of Cardiology, American Heart Association and the German Cardiac Society.