allison hanes: women's heart health is far too often ignored

by allison hanesthis is the kind of true story that gives wendy wray nightmares.last year, a 44-year-old south shore woman entertained a house full of friends and family over the easter weekend, despite feeling under the weather. she had discomfort in her chest and pain going down her left arm. she was sweaty, nauseated and short of breath. she told everyone how lousy she felt, but managed to soldier on. the next morning, the woman dropped dead of a heart attack, leaving behind two young children.what gets to wray, who started a one-of-a-kind cardiac clinic at the mcgill university health centre aimed at preventing exactly this type of tragedy, is that neither the woman (who was not a patient), nor her family, thought to seek help.“not one person in her home thought to say to her ‘you need to go in and get checked,’ or ‘i’m going call 911.’ had a man had the same symptoms, the phones would have been out, and people would have been calling in 30 seconds,” lamented wray. “it’s got to stop. we can do better.”this is what makes wray a passionate advocate and intrepid pioneer when it comes to women’s cardiac health. in 2009, she launched the women’s healthy heart initiative at the muhc. on thursday, she will attempt to amplify her critical message with an information booth and yoga sessions, as part of wear red canada, a national day of awareness.the whhi is canada’s first and only nurse-led cardiac clinic for women. but it’s unique in many ways. not only do nurses and cardiologists work shoulder-to-shoulder, rather than in a more traditional top-down hierarchy, the practice is also patient-centred, allows women to refer themselves and is funded entirely by donations, many of which come by way of the muhc foundation.to date, it has treated more than 1,000 montreal-area patients, working to prevent disease, as well as educate and empower women about one of their leading causes of death.“when i give public talks and i inform women that one in 89 women die of ovarian cancer, one in 25 of breast cancer, but one in three die of heart disease or stroke, there’s always an audible gasp in the room,” wray said. “and then the very next things is: ‘why don’t we know that?’ well, that’s a darn good question.”heart disease is still largely thought of as a men’s ailment, even though women are more like to die within a year of a heart attack and risk factors like diabetes, smoking and physical inactivity are more potent in women.it’s also more difficult to detect a narrowing of the arteries in women. they experience issues later in life —  age 71, on average, a decade after men. women have natural protections that keep cholesterol levels in check, but they wear off at menopause. pregnancy complications, like pre-eclampsia and gestational diabetes, can be predictors of future heart problems.the bad news is that too few people know these things, said wray. but the good news is that most of the major risks can be modified with better diet and exercise. this is why the whhi focuses on prevention.wray fought hard to allow women to refer themselves to the clinic — ie: just call up and make an appointment — something that is virtually unheard of in quebec’s waiting-list plagued health system. back in 2009, very few women had family doctors from whom to get a referral and some general practitioners refused to give them one. some come with symptoms, but most want to avoid the issues that killed or left loved ones ailing.cheryl bertoia found the clinic after suffering a heart attack in 2014. she’d been travelling in asia and her native united states when she felt something “wasn’t quite right.” back at home in montreal, the 58-year-old says the whhi provided personalized care on the road back to health.“it’s emotionally supportive. it’s very much a clinic run for women, by women,” bertoia said. “they know you, they care about you.”even if heart disease is a leading causes of death in women, the whhi receives no government money. but in wray’s view, it’s a model that could be deployed across the health system, if only there was more public funding for prevention and more willingness to tap the experience of nurses.“if one in three women die of heart disease or stroke, when you look around the cardiac units, look in the cardiology departments, there aren’t many women. so where are they? it’s not that they don’t exist, they’re not in the system. they don’t recognize the symptoms, they’re not telling their doctors, they’re not getting the testing and the diagnosing. it’s a whole cascade,” she said. “so i think for 2020, i really want women to think about heart disease, to be more aware, and to act.”ahanes@postmedia.com