Heart disease clinic for women in Halifax a dream come true for cardiologist

When cardiologist Dr. Sharon Mulvagh moved home to Canada from the United States just over a year ago, she had one goal in mind: to open a special clinic aimed at addressing an underdiagnosed and often deadly disease in women — heart disease.

Now that dream has come true.

The Maritime Heart Centre's Women's Heart Health Clinic started accepting patients at the QEII Health Sciences Centre in Halifax in October.

Patients need to be referred by their doctors, then Mulvagh and clinic co-director Dr. Helen Bishop evaluate their medical history and make recommendations for prevention and treatment.

Mulvagh said she only knows of one other clinic in Canada specifically geared toward women at high risk of heart disease, and that's in Vancouver.

Surprising symptoms

Unlike men, women typically don't experience the "classic Hollywood heart attack," Mulvagh told the CBC's Information Morning.

Alongside discomfort in the chest, she said, their symptoms might include shortness of breath, nausea, vomiting, as well as back or jaw pain. 

Women's symptoms "may be a little more complicated to understand and tease out," Mulvagh said, "but we cannot dismiss them."

Often heart attacks in women are not due to large blockages in the arteries, like men, she said. Instead, there might be a problem with their small vessels, or even a tiny tear, Mulvagh said, and this often leads to misdiagnosis.

Women who've experienced complications during pregnancy — such as high blood pressure or gestational diabetes  — are at risk, she said. As are those who've undergone treatment for breast cancer.

Sometimes heart attacks occur in women under the age of 55 who list no risk factors for heart disease, she said.

"They don't smoke, they're not diabetic, they don't have cholesterol problems," Mulvagh said, "but they end up with a heart attack and they're in their 40s."

The 30 to 40 patients who have been referred to the clinic so far often have a lot of questions, she said, because "they've been doing everything right" and suddenly they're having a heart attack.

Healthy lifestyle key to prevention

Mulvagh said she and her co-director will typically review each patient's medications and suggest lifestyle changes. Being healthy, physically active and not smoking is "extremely important," she said, when it comes to avoiding heart disease.

"I rarely see a heart attack in a woman under 50," Mulvagh said, "if she's not a smoker."

Mulvagh, who was the director of the Women's Heart Clinic at the Mayo Clinic in Rochester, Minn., before returning to Canada, said Canadians are "about a decade behind" Americans when it comes to recognizing the prevalence of heart disease in women — and the consequences have been deadly.

"Heart disease is an equal opportunity killer," said Mulvagh. Women experience heart disease as much as men do, she said, or maybe even more.

A report by Heart & Stroke released earlier this month showed the percentage of deaths in hospital from those admitted with a heart attack was higher among women than men.

The report also said early heart attack signs are missed in about 78 per cent of women.

Kathryn Rand with the Heart and Stroke Foundation of Nova Scotia, said she's "delighted" the new Halifax clinic is up and running, as it will provide Nova Scotian women with "specialized treatment and care."