India, Sept. 29 -- Over four decades of surgery and counting, I have lost track of the women who arrived at my hospital a full day, sometimes a week, after their heart attack. There have been two occasions when women came in to report heart disease in their husbands. Over the course of their husband's surgery and recovery, the women did a casual check-up, only to discover that they had full blown heart disease too.

It's not that they were careless; most had been managing households, jobs, in-laws, and children with a discipline I have rarely seen matched. They arrived late because nobody, including many doctors, recognised what was happening to them. Chest pain is what we are trained to look for. Women often present with breathlessness, ...