Quick – what is the most common cause of death for women in the US?

It’s not breast cancer, despite (or perhaps thanks to) the huge levels of funding and awareness it gets over other diseases.

It’s not any type of cancer, in fact. Neither is it accidental injuries, strokes, or any of the chronic respiratory diseases like asthma or emphysema that are more common in women.

It’s actually heart disease. But thanks to years of being basically ignored in research, awareness of female heart disease and heart attacks is so bad that it now accounts for over one-fifth of all deaths in women.

New research published this week in the journal European Heart Journal: Acute Cardiovascular Care provides one reason for this. For somebody suffering a heart attack, time is critical, with faster treatment meaning more heart muscle saved, less heart failure in the future, and a lower risk of death. But according to the study, which looked at over 4,000 people over a period of 16 years, women are waiting about 37 minutes longer than men before they even contact medical services.

“Women having a heart attack seem to be less likely than men to attribute their symptoms to a condition that requires urgent treatment,” explained study author Matthias Meyer in a statement.

Meyer attributes this problem to heart disease’s long-standing reputation as a “man’s problem”. Not only are (particularly male) doctors unable to recognize heart attack symptoms in women – something that costs women their lives at a rate up to three times higher than men – but it seems women themselves don’t know what to look out for.

“Women and men have a similar amount of pain during a heart attack, but the location may be different,” Meyer explained. “People with pain in the chest and left arm are more likely to think it's a heart attack, and these are usual symptoms for men. Women often have back, shoulder, or stomach pain.”

Aiming to spread awareness of what heart attacks can really be like in women, one nurse took to Twitter earlier this week to explain her own experience. She quickly went viral as people shared her description of the non-stereotypical symptoms of her heart attack.

The study did turn up some good news. For both women and men, medical care is being delivered with fewer and fewer delays – and those delays that do occur are not associated with an increased risk of death when patients get to the hospital.

“The acute complications of a heart attack drive in-hospital mortality rather than delays,” explained Meyer. “But we do know from previous studies that delays predict long-term mortality.”

“Every minute counts when you have a heart attack,” he added. “Look out for moderate to severe discomfort including pain in the chest, throat, neck, back, stomach or shoulders that lasts for more than 15 minutes. It is often accompanied by nausea, cold sweat, weakness, shortness of breath, or fear.”