In all of American medicine, there is no better example of the disconnection between what we know and what we do than in the case of women with coronary artery disease. While the different symptom patterns in women with abnormal heart arteries are receiving more attention, even women who properly engage the system very often receive medical care that is not appropriate and leaves them in great danger while adding layers of needless cost. The woman who is seen in the emergency room for chest pain or other symptoms suggestive of coronary disease will be evaluated under an outdated scientific paradigm aimed at finding blocked arteries. She will have a stress test done and /or a cardiac catheterization. If these tests are normal, the patient will be told that the symptoms are not related to her heart. Every other week, I see a woman who has had symptoms of coronary artery disease and has been told that the problem is her esophagus or worse depression. She is told in effect: “Go home, take your Valium and Prozac, you will be fine!” What she has been told is wrong-too often dead wrong!