February is heart month, a good time to focus on how to protect our hearts and reduce the risks that can impact our cardiovascular health. At a Speaker Series, interventional cardiologist Dr. Mina Madan discussed the particular risks faced by younger women.
While heart health is important for everyone to think about, it is especially significant for women. According to the Heart and Stroke Foundation, heart disease and stroke are the leading cause of premature death in women in Canada.
At Sunnybrook Health Sciences Centre, many doctors and scientists are engaged in clinical work and research focused on how to better understand, prevent and treat heart disease in women.
When it comes to heart attacks, several studies have shown that women in Canada tend to have worse outcomes than men – although in Ontario there is some evidence this gap is narrowing.
Younger women are considered an especially high-risk group yet they often experience more delays in diagnosis and treatment.
Over the past decade, more attention has been paid to heart attacks in women in an attempt to address these treatment disparities. However, more research and education are needed.
One condition that is seeing increased awareness within the medical community is Spontaneous Coronary Artery Dissection, also known as SCAD.
SCAD is an uncommon, underdiagnosed emergency condition that occurs when a coronary artery tears or bleeding occurs within the coronary arterial wall. It can block blood supply to the heart, causing a heart attack. This is different from a traditional heart attack resulting from “cholesterol plaque” build-up or rupture.
SCAD most commonly affects women in their 30s, 40s and 50s. It can be seen in up to a third of cases of younger women with heart attacks.
People who develop SCAD often have predisposing conditions such as fibromuscular dysplasia (a condition that narrows or enlarges the arteries) or precipitating stress factors like intense exercise or emotional strain.
Patients seen in emergency rooms will often have symptoms identical to a regular heart attack, such as chest pain radiating down the arm, nausea and vomiting. The best way to diagnose SCAD is with an angiogram (an X-ray of the coronary arteries and vessels).
Luckily, unlike regular heart attacks, SCAD often heals without invasive intervention and can be treated and managed with medication and lifestyle changes.
In 2018, Sunnybrook’s Schulich Heart Program opened a SCAD clinic to better serve people with this condition by providing specialized evaluation and treatment and coordination of long-term follow-up care.
