'Women have been shortchanged': Report highlights promising research in cardiac emergency killing young women

Two-thirds of research into heart and stroke disease is based on cases involving men but a Heart and Stroke Foundation of Canada campaign to address the gender gap is making gains.

Heart & Stroke launched campaign to address research gap between men and women

Sucdi Barre had a heart attack after giving birth to her son, Yonis, but it took doctors four days to learn what caused it. (Kory Siegers/CBC)

Hours after her emergency caesarean section, knife-like pain shot through Sucdi Barre's back and arm. She was told to walk it off, until a doctor finally ordered an angiogram.

"I walked it off until I couldn't breathe anymore," Barre recalled. "When they said, 'You had a massive heart attack,' I was like, 'Oh, my God. And you made me walk it off?' That was shocking to me."

It took four days and three teams of Edmonton-area doctors to figure out the cause. Spontaneous coronary artery dissection (SCAD) is an under-diagnosed condition where the heart's artery walls start tearing apart.

By that point doctors had implanted a stent, triggering more heart attacks. Barre was 34, and her heart was functioning at three per cent.

Now, 2½ years later, Barre's story is highlighted in a new report called A fighting chance, from the Heart and Stroke Foundation of Canada.

"When it comes to heart and brain health, women have been shortchanged," the report says. 

The report says two-thirds of research into heart disease and stroke is based on cases involving men. In 2018, Heart & Stroke launched a campaign to address the inequity.

"This research gap is costing lives," the report says, noting heart disease and stroke are the No. 1 cause of premature death for women in Canada. "But new research advances are closing that gap."

The campaign has created a national research network dedicated to women's heart health and funded dozens of Canadian scientists.

One of them is Dr. Jacqueline Saw, a professor in cardiology at the University of British Columbia, who is Canada's leading expert in SCAD. 

Dr. Jacqueline Saw is Canada's leading expert on SCAD. (The University of British Columbia)

Saw said 90 per cent of SCAD patients are women, who are young and otherwise healthy and have no traditional risk factors or warning signs.

"Women themselves actually don't even present to the hospital because they don't think this is a heart attack symptom," Saw said. "Young, otherwise healthy women coming in with chest discomfort might just end up being either considered for other less-critical illness or just simply dismissed as anxiety."

Adding to the challenge, SCAD can be hard to detect on regular angiograms. And in cases like Barre's, conventional treatment using stents or blood thinners can lead to more tearing, the report said.

"We need to have a high index of suspicion when women present with a heart attack," Saw said. "We need to think about SCAD as a very potential and important cause of heart attack."

Saw and her research team have developed a way of analyzing angiograms that can help doctors identify SCAD. They are also studying the genetics of 1,000 patients with SCAD and tracking the effectiveness of treatments.

"I think that will be instrumental to help us understand: what are the new genetic risk factors for patients with SCAD." Saw said.

As for Barre, her heart now functions at 40 per cent and she no longer needs a mechanical pump. She said she's grateful for the energy that allows her to play and care for her son, Yonis, run an agency that assists newcomers and advocate for heart health.

"As women we also need to self-advocate more actively and not put ourselves on the back burner of life because we're so focused on caring for everybody else," Barre said.