If heart disease in women is the big killer, why do so many ers and doctors send them home with symptoms?

Judgement calls: Not all symptoms are related to heart disease. The hard part of our job often is to weigh all the symptoms, and risk factors and make a calculated decision on how likely the symptoms can be explained by heart disease that also requires admission. It's not an easy task. You simply cannot admit every woman (or man) with symptoms and low probability of heart disease.