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This is why we need more medical research focused on trans and intersex bodies. It's honestly a travesty that it hasn't been studied much, largely due to the pushback from oppressive governments and transphobes. The problem extends beyond trans people, so much medical research is modeled on white cis male bodies, but I'm sure you're already aware of that issue.
Transition affects nearly every part of the body. It's already known that trans brains more closely resemble their cis counterparts rather than their sex assigned at birth (citations: NIH.gov, Scientific American). It wouldn't make sense to treat a trans woman as a cis man for brain imaging. In trans men, testosterone deepens the vocal chords and can even slow down or stop periods. In trans women, estrogen shrinks the prostate and can even reverse male pattern baldness. Surely there are other effects on internal medicine, both positive and negative
Part of trans liberation involves sponsoring more research in this topic. In your heart attack example, has it been scientifically proven that the symptoms are immutable with transition? Does the amount of time someone's been transitioning affect it? These are genuine questions, I don't know the answers to them
I agree that more research needs to be done. I don't know the answers to those questions either. I'm sure there's lots more knowledge out there that is known that I just don't know, but there's also tons of knowledge that's lacking, the same way that there's tons of knowledge that's lacking about women's bodies. Humans are fascinating and there's so many different factors that can affect medical presentations or risk factors.
Unfortunately in the current climate that research is considered too "woke" to "waste" money on, so people will continue to suffer from insufficient medical care even when their providers are genuinely trying their best.