Previous studies suggest that the presentation, treatment, and outcome of acute coronary syndromes differ between women and men. Women arriving to the emergency department for acute coronary syndromes are usually older, have a higher prevalence of diabetes and hypertension, show a longer delay from symptom onset and have a slightly higher in-hospital mortality than men. In our experience including 4843 emergency department admissions for chest pain, the time to presentation was longer and diagnostic mistakes more frequent in women than in men, whereas medical treatment and the rate of revascularization procedures were similar. The introduction of Chest Pain Units with pre-defined diagnostic and therapeutic procedures should facilitate the early identification of highrisk female patients, reduce inappropriate hospitalizations, and improve the diagnosis and outcome of coronary heart disease.