Roz Green
Clinical Marketing Partner, Roche Diagnostics UK and Ireland
Heart attack symptoms aren’t one-size-fits-all. High-sensitivity testing is closing the cardiac care gap.
Differences in how heart attacks present, and whether they’re recognised, mean that some patients face additional challenges and delays in diagnosis. Women are 50% more likely to receive the wrong initial diagnosis when experiencing a heart attack.1 This is a reminder that heart attack diagnosis is complex and that the tools, evidence and pathways that support clinical decisions matter.
A familiar, but incomplete, picture
Ask someone to picture a heart attack, and there’s a good chance they’ll imagine sudden, acute pain, perhaps someone clutching their chest. It’s a familiar image, but it’s also incomplete.
Heart attacks can present in different ways. Women may experience chest pain, but they may also experience unusual fatigue, nausea, breathlessness or discomfort in the back or jaw.2 Symptoms don’t always follow the script that most people expect, and when the script changes, the response needs to change, too.
What can change the picture?
Doctors and nurses have lots of clinical information to work with to determine a heart attack, including symptoms and an ECG. Another important piece comes from a simple blood test that measures a protein called troponin.3 Troponin is released into the blood when the heart muscle is damaged. Measuring it can help clinicians determine a heart attack. Sometimes the blood test is repeated to see whether the level is rising or falling, giving the clinical team a clearer picture of what’s happening.4
The latest high-sensitivity tests can detect much smaller amounts of troponin. That means clinicians have more information to work with, particularly when the answer isn’t immediately obvious.
This matters for women, as they generally have lower levels of troponin than men.5 Historically, diagnostic approaches have used one threshold for women and men, which may have made some heart attacks in women harder to identify.
The latest international definition of a heart attack takes this difference into account, incorporating separate troponin thresholds for women and men.6 And with new technology, clinicians may opt to use sex-specific thresholds, depending on the assay, local pathway and clinical judgement. The aim is to reduce the risk of heart attacks in women being overlooked. It’s an important development because equality in healthcare starts with recognising that the same approach doesn’t work equally well for everyone.
Women are 50% more likely to receive the wrong initial diagnosis when experiencing a heart attack
What difference can a new test make?
A new generation of cardiac troponin testing, using Roche Diagnostics’ Elecsys® Troponin T hs Gen 6 assay, is being introduced in the UK and Ireland at St. Vincent’s University Hospital in Dublin. This assay, with sex-specific thresholds, will give clinicians working in a busy emergency department access to more analytically sensitive troponin testing.
However, innovation in emergency care isn’t only about what a test can detect, but also about making those tests more reliable and robust. For example, haemolysis is a relatively technical-sounding word for something that can have a very practical consequence. Red blood cells can break down in a blood sample, interfering with the result. If that happens with a troponin test, the sample may have to be rejected, and the patient may need to give blood again. Repeat testing can delay clinical decision-making in moments when answers are needed quickly.
The Elecsys® Troponin T hs Gen 6 assay is designed to be significantly more resistant to haemolysis than previous generations.7 That can mean fewer unusable samples and fewer repeat blood draws, helping patients and clinicians get answers sooner, while taking some avoidable pressure off emergency departments and laboratories. These may sound like small improvements, but in a busy emergency department, they can have a big impact.
Closing gaps in heart attack diagnosis will take more research, greater awareness, effective clinical pathways and collaboration across healthcare. Every improvement in the way heart attacks are recognised, investigated and diagnosed brings us closer to a system that works better for everyone.
[1] BHF Press Office. (2016). Women are 50% more likely than men to be given incorrect diagnosis following a heart attack. https://tinyurl.com/sec8n2a2.
[2] BHF. (2026). Women and heart attacks. https://tinyurl.com/5n6zcn2w.
[3] NHS. Heart attack. https://tinyurl.com/bdddrm4f.
[4] Goss, R. (2024). What is troponin? https://tinyurl.com/3m7akd3z.
[5] de Bakker, M.et al. (2023). Sex differences in cardiac troponin trajectories over the life course. https://tinyurl.com/572faweb.
[6] Gregory, A. (2026). New heart attack definition promises better care for women. https://tinyurl.com/3mermxm7.
[7] F. Hoffmann-La Roche Ltd.(2025). Elecsys Troponin T hs Gen 6 Method Sheet. (v1.0).
