Heart of the matter
Women’s warning signs of heart disease different than men’s
Sudden fatigue so extreme she could barely walk. In a Florida airport, 70-year-old Helga Campbell had to sit down. “All of a sudden, I thought, ‘I can’t do this,’” she said. Her exhaustion didn’t make sense. The Niagara Falls woman was full of energy during her vacation yet wondered aloud to husband, Wayne: “Am I having a heart attack?” Back home in Canada, she had an angiogram, a test that takes X-ray pictures of the coronary arteries and the vessels that supply blood to the heart. The result was confusing: no blockages. She was sent home. Still, she couldn’t climb the steps to the second floor of her house without stopping to catch her breath and talking on the phone was exhausting. Worried, she went to the emergency department. An astute cardiologist took the time to talk to Campbell and discovered that her daughter had died weeks earlier. Katey, 33, died by suicide after years of struggling with mental health and addiction issues. No one had thought to ask Campbell about stress in her life. The doctor connected the dots and diagnosed Helga
with stress-induced cardiomyopathy — broken heart syndrome — a disease of the heart muscle that reduces its ability to pump blood. She was given medication and is now back to her normal self. “Losing my daughter was an ongoing grief,” she said. “Your body does react, even if you’re not aware of it.” Campbell’s experiences illustrates the findings of a recent Heart and Stroke Foundation report of women’s heart health. Women are unnecessarily suffering and dying from heart disease because they are underresearched, under-diagnosed, under-treated and under-supported during recovery, it states. The reality: • Early heart attack signs were missed in 78 per cent of women. • Every 20 minutes a woman in Canada dies from heart disease. “I’m very concerned about women,” said Dr. Olga Toleva, interventional cardiologist in Winnipeg and a foundation spokesperson. “I see a lot of women who come in with acute heart attacks,” she said. “And quite often, they were delayed in treatment and diagnosis because it was felt that something else was wrong with them.” Indeed, the report suggests that both women and their doctors are slow to identify the early, more subtle signs of a heart attack — shortness of breath, weakness, fatigue, dizziness and nausea. “It is frustrating,” said Toleva. “It’s very complex. Women have different presentations than men. And most of our knowledge about heart attack is based on men.” In fact, even if heart problems are suspected, the typical angiogram test used to find blockages and confirm a diagnosis might not be effective for some women, she said. It might not catch problems with smaller coronary blood vessels, or spot SCAD — spontaneous coronary artery dissection — the underlying cause for about 25 per cent of all heart attacks in women under age 60. Women need to self-advocate for themselves, and if they suspect heart problems, ask for an ECG and referral to a specialist. At Brock University, Sheila O’Keefe-McCarthy, assistant nursing professor and primary investigator with the Heart Innovation Research Program, is working to educate women. Her sister, Ann, died of a heart attack at age 44. No one recognized her warning signs. The centre has partnered with Heart Niagara to develop an early warning sign education strategy targeted at women and clinicians, that includes graphics, videos and a screening scale. Ultimately, she hopes it will save lives. “That would be the best gift we could ever imagine,” she said.