Important new research from the National Heart, Lung, and Blood Institute’s WISE study (for Women’s Ischemia Syndrome Evaluation) has shown that women frequently have the pain that’s associated with blocked arteries, but that testing—called angiography—reveals no blockage. These women are not treated as being at risk of heart attack.

But the truth for many of these women is that cholesterol is building up in very small arteries of the heart, causing narrowing, reduced oxygen flow to the heart and pain that can be similar to that of people with blocked arteries. But the plaque does not show up when doctors use standard tests.

WISE investigators found that the majority of women with “clear” angiography who are not diagnosed will continue to have symptoms, a declining quality of life and repeated hospitalizations and tests. These women need to be getting treatment for their condition.

If you have experienced something similar—going to the doctor because of chest pain only to find out that tests don’t reveal a problem, it might be time to talk about the WISE study results with you doctor.