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.

Learn more about the clinic at sunnybrook.ca/SCAD.

The post Women’s Heart Health: Working towards better understanding and care appeared first on Your Health Matters.

Dr. Maria Terricabras is an Electrophysiology Fellow in the Sunnybrook Schulich Heart Program.  

You specialize in problems with the heart’s rhythms, which is really interesting. Do you come from a family of doctors?

No, and I’m actually the only one in my family. I became interested in medicine when I was about 14 years old, and remember telling my parents then that I wanted to become a doctor. They thought I would eventually change my mind, but here I am!

So do you actively avoid things that send your heartbeat into overdrive, like rollercoasters?

I love rollercoasters! I have a healthy heart, so have no reason to be afraid of them. I grew up in Spain and remember going to Eurodisney a lot when I was younger. I haven’t been to any theme parks in Canada yet, though. I also love watching scary movies. The Shining is my favourite because it builds tension without being too explicitly violent.

Diet can have a huge impact on our hearts. What’s your approach?

Being from Barcelona, I’m used to eating a Mediterranean diet. That means lots of lentils and beans, having fish once a week and not eating a lot of red meat. Just like back at home in Spain, I don’t fry anything and bake it or grill it instead. I try to avoid foods that are higher in fat, like sauces. On salads, all you need is a bit of balsamic vinegar and some olive oil! I also normally have fruit for breakfast and most desserts. I’ve been raised on this approach to eating so it’s not hard to do.

There must be some cheat days in there…

I love cheese like blue, brie and camembert, so that’s my pleasure on the weekends. My husband and I really enjoy food and like to go out to restaurants on the weekend as well. I’m careful during the week so I can indulge a bit more for a day or two.

What about exercise? That’s also an important part of heart health.

Getting in exercise every day is hard because of my schedule. When I’m in the lab, my work days can be up to 12 hours long. When I’m at the hospital, I do make a point of avoiding elevators and taking the stairs as much as possible. On weekends, my husband and I like to go on hikes and get over to the gym a few times.

Do you sleep well?

For sure, I make sleep a priority and aim for at least eight hours per night. That often means I’m going to bed early, but I don’t function well if I’m tired.

It sounds like you practice what you preach to your patients.

I think I walk that balance well, but I don’t do some things I often advise my patients. I have a healthy heart so I don’t have to strictly avoid salt. I also never wear a smartwatch to monitor my own heart rate, which some people find surprising. While these can be great tools for some people, especially those living with and at higher risk for heart issues, some people can become a bit obsessed with them.

The post How to live like the experts: Dr. Maria Terricabras on how she maintains good heart health appeared first on Your Health Matters.

February is Heart Month, and one way to care for your heart is by eating well. Dr. Rahul Jain, Family Physician at Sunnybrook, and Karen Fung, Registered Dietitian at Sunnybrook, share some ways individuals and families can incorporate heart-healthy eating habits into everyday life.

Have fun with cooking

Dr. Jain says one way to encourage Canadians to stick to their healthy eating goals is to remind them that eating nutritious foods doesn’t have to mean bland, boring meals. That’s why the Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE), of which Dr. Jain is the co-chair, collaborated with a professional chef from Switzerland, Jaroslav Guzanic, to create a teaching video on how to prepare a delicious, heart-healthy meal (according to Canadian nutrition guidelines). In the video— which you can watch above— Jaroslav prepares a vegetarian version of the Moroccan dish tagine.

“The teaching video aligns with Canadian nutrition guidelines on best practices to prevent and manage cardiovascular disease,” says Dr. Jain. “But it’s about having fun with the food as well. And to pick up culinary skills. [Cooking] can be a fun activity.”

Dr. Jain and Karen say there are some key things Canadians can do to make meals more heart-healthy:

Look for polyunsaturated fats 

One recommendation for heart-healthy eating is for Canadians to reduce the amount of saturated fats they eat and instead opt for unsaturated fats, which include poly- and mono-unsaturated fats.

“Vegetable oils are excellent: sesame, avocado, sunflower seed oil, canola oil, olive oil,” Karen says. “The exception is coconut, which is high in saturated fats.”

Olive oil is likely the most accessible, but some people might be hesitant to cook with it: Karen says not to worry about that.

“The common misconception is that we can’t cook with olive oil, but we can. We just can’t use it at very high heats like barbecuing,” she says. “If you’re making a stir-fry or frying an egg, you can totally use olive oil.”

In addition, nut, seeds and nut/seed butters as well as avocados are sources of unsaturated fats. For Omega-3 fats, people can eat fish such as salmon, rainbow trout, mackerel. Most white fish does not have significant amounts of Omega-3. Karen recommends fresh, not canned or cured versions.

Up the fibre

“There’s a small percentage of Canadians who meet the fibre requirement on a daily basis,” says Karen. The daily recommendation for fibre intake is at least 25 grams for women and 30 grams for men. Karen says Canadians may benefit from focusing on increasing the amount of soluble fibre in their meals because it’s often overlooked.

Soluble fibre is beneficial for heart health, Karen says, and it can be found in whole grains, oats, barley, lentils, chickpeas and beans. The fibre typically found in fruits and vegetables is known as insoluble fibre.

“We know about fruits and vegetables being a fibre source, but we forget about whole grains and legumes possibly being an even better fibre source,” she says. “Because of the low-carbohydrate fads and trends, people have shied away from whole grains and legumes.”

Both are important, but think about upping the amount of soluble fibre specifically.

Watch the sodium

Hypertension Canada recommends Canadians eat less than 2000 mg of sodium per day, which is equal to one teaspoon of salt. Currently, the average Canadian consumes closer to 2800 mg of sodium per day. Too much sodium increases the risk of high blood pressure, which increases the risk of heart disease and stroke.

Dr. Jain says about one in four Canadian adults have high blood pressure, and about 30 per cent of those cases are related to high sodium in the diet.

“Salt attracts and draws water, and if you have more retention of fluid, you have increased blood volume and that results in increased blood pressure,” says Dr. Jain.

Karen says one of the easiest ways to reduce sodium intake is to cook meals at home and limit the use of processed and canned foods such as frozen dinners or canned soups.

“Replace [salt] with other herbs and spices,” says Dr. Jain, adding the cooking video with Jaroslav is a great example of how to use spices and herbs to create flavour without using as much salt. “For example, adding basil and oregano to soups and pasta, or garam masala and cumin to lentil dishes or stews.”

Progress, not perfection

Making small changes will add up, says Karen, so don’t feel as though you have to make sweeping changes to your eating habits immediately.

“It’s about the big picture,” she says.

These are general guidelines, suitable for most Canadians to prevent heart disease, but Dr. Jain says for individuals who have chronic conditions such as diabetes, high blood pressure or heart failure, it’s important to speak with your family physician or a dietitian because they can provide specific recommendations for your situation and needs.

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