Jane McIntosh suffered a heart attack in December 2022 after a cardiologist brushed off her symptoms as anxiety.
One woman’s life is lost every 16 minutes.
That’s one of the grim statistics quoted in a new report by the Heart & Stroke Foundation titled System Failure: Healthcare inequities continue to leave women’s heart and brain health behind.
The report shows that heart disease and stroke claimed the lives of 32,271 women in Canada in 2019 – one woman’s life every 16 minutes.
Two-thirds of participants in clinical trials on heart disease and stroke have been men. Yet The Heart & Stroke Foundation says that in 2019, 20 per cent more women in Canada died of heart failure than men and 32 per cent more women died of stroke than men.
One of the major shortcomings is misdiagnosis. Half of women who experience heart attacks have their symptoms go unrecognized, and they are less likely than men to receive the treatments and medications they need or get them in a timely way.
Jane McIntosh, a fit, active 68-year-old Kelowna resident with no risk factors suffered a heart attack last December.
Six months earlier she had felt tightness in her chest and was referred to a cardiologist who did two stress tests on her heart but brushed off the symptoms as likely stress-related anxiety.
“I do know if I hadn’t been told that when I did have symptoms starting before my heart attack, I would have viewed them in a different way,” says McIntosh.
Another factor in her case is that Jane does not have a family doctor. She used Telus Health to refer her to a cardiologist.
She wants to raise awareness that the warning signs for women can be quite different than for men.
“I had an occasion where I had a lot of pressure all of a sudden in my chest and in my jaw, but absolutely no pain,” says McIntosh, who was driving with some friends at the time her first episode happened.
“I thought if it doesn’t stop in two minutes I’ll pull over and fess up. But it did stop in two minutes and I felt completely normal afterwards.”
While intense chest pain is often the only symptom for men, women can experience more subtle signs like discomfort in the neck, jaw, shoulder, upper back or upper belly; shortness of breath; nausea; or vomiting.
Pregnancy and menopause are also risk factors that are often overlooked.
Certain types of heart conditions are more common in women including strokes, myocardial infarction with non-obstructive coronary arteries (MINOCA) and spontaneous coronary artery dissection (SCAD). Women who experience two of the three main types of heart attacks are more likely than men to die or develop heart failure and women who experience stroke are at higher risk of dying.
“We simply do not know how to treat forms of cardiovascular disease that are more common in women,” says Dr. Husam Abdel-Qadir, Women’s Heart and Brain Health Chair at Women’s College Hospital in Toronto.
In Vancouver, research is underway at a clinic run by the only certified women’s heart cardiologist in Canada.
“Number one, I think we want to reassure women that it’s not that they’re anxious that they’re experiencing these things. There’s an actual physiological cause for it. Because when I speak with these women you can see that they’re very anxious. Rightly so, because they have these symptoms that doesn’t have a diagnosis and as a result of that doesn’t have a treatment,” says cardiology student Mahraz Parvand.
She says that often their clients have spent months trying to get answers. She hopes that the Leslie Diamond Women’s Heart Health Clinic can do more to help patients outside the Lower Mainland.
“Many of these women who have cardiovascular problems live in rural and remote areas and they don’t have access to our clinic. So we’re trying to advance our clinic to offer more telehealth visits and get more referrals from those areas,” says Parvand.
The Heart & Stroke Foundation says strides are being made.
Over the past five years it has invested $5 million from the federal government and $5.5 million from partners and donors into women’s heart and brain health research and awareness. It has also launched the Women’s Heart & Brain Health Research Network and now requires all research it funds to include sex and gender in its design.
Still, more needs to be done, including gender equity in the spending of research dollars.
“Transforming the state of women’s heart and brain health will involve changing policies, systems, attitudes and behaviours. It will take a massive collaborative effort to break down the barriers that create inequities,” says Doug Roth, CEO, Heart & Stroke. “Heart & Stroke is committed to working with our partners to ensure all women in Canada receive the care and support they need.”
February is Heart Month in Canada.