Women do not always have warning signs for heart disease, so women at risk should talk to their doctors about screening. See more pictures of women's health.

The lack of "classic" symptoms of coronary heart disease makes it difficult to identify those who should undergo some form of testing. It's important for women to talk with their doctor about such atypical symptoms that might signal coronary heart disease and to examine other risk factors that may be an indicator.

Of course, women with recognized symptoms should be screened, and women with a significant risk factor, such as familial hyperlipidemia or diabetes, should also be screened and may be advised to undergo further testing even if they have no symptoms.

In the past, many symptoms, such as angina, were thought to be primarily a result of fixed plaques that limited blood flow to the heart. Today, however, this traditional view is being challenged.

In fact, the Women's Ischemia Syndrome Evaluation study researchers found that in approximately one-third of cases in which women show little or no narrowing, endothelial dysfunction may be to blame; cells that line the walls of blood vessels, called the endothelium, may limit blood flow. Also, in some cases, plaque in women's arteries may build up in a smooth, even pattern -- unlike the typical lumpy plaque build-up in men's arteries -- which standard tests don't detect.

As a result, it's important for women suffering symptoms of coronary heart disease but who do not show narrowed arteries on an angiogram to undergo further testing to determine the underlying cause.

Although it can be an unknown risk factor in women, there's no need to fear coronary heart disease if you follow the advice in this article to know when to get tested.

For more information on coronary heart disease, check out the links on the next page.