P.E.I. woman reflects on heart blockages following new report citing gaps in women's health care

Angie MacCaull says she never had 'typical heart attack symptoms,' but ended up needing triple bypass surgery. (Laura Meader/CBC - image credit)
Angie MacCaull says she never had 'typical heart attack symptoms,' but ended up needing triple bypass surgery. (Laura Meader/CBC - image credit)

Five years ago, Angie MacCaull says she was in the best shape of her life and would not have considered heart issues to be the source of her sudden pain.

"Aching from my elbows to hands," she said. "I had some abdominal discomfort, probably around my diaphragm area. And no shortness of breath, no chest pain, no arm pain, no jaw pain. So not your typical heart attack symptoms."

At the time, several negative tests cleared MacCaull to travel with her husband.

However, her symptoms worsened and the severity of her condition brought them back home to Prince Edward Island. It would take four hospital visits in the same week to realize she had eight blockages in her heart and required triple bypass surgery.

Years later, she recalls her experience as an example of the gaps in women's health care — one that is echoed in a report released on Feb. 1 by The Heart and Stroke Foundation. The report describes a lack of awareness, research, diagnosis and care when it comes to heart and brain health for women.

"Half of women who experience heart attacks have their symptoms go unrecognized," according to the report, adding heart disease and stroke are the leading cause of premature death in women.

It said biological and social inequities related to race, ethnicity, gender, sex, Indigeneity, disability and socioeconomic status can affect a woman's likelihood of experiencing certain types of heart and brain conditions.

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Women are also susceptible to distinct factors that put them at risk, such as pregnancy and menopause. Other risks include smoking, obesity, high blood pressure, diabetes and depression.

MacCaull thinks the tests to diagnose her condition had failed her because the information related to heart health is based on research with men.

Women may have some of that chest pain, but more often they'll also have pain and discomfort in their neck, their shoulders, their upper back — Patrice Lindsay

Patrice Lindsay, co-author of the study, agrees and said it's part of why women are not receiving the necessary and timely treatment they require.

"Women may have some of that chest pain, but more often they'll also have pain and discomfort in their neck, their shoulders, their upper back. And nausea, vomiting, and even shortness of breath," she said. "When you think of those symptoms, you don't automatically think, 'Oh my gosh, heart attack.'"

The dismissal of symptoms in women, Lindsay said, is one of the reasons why many hesitate reaching out to health-care services — some even doubting their symptoms before seeking help.

She said the published report is a step in the right direction. But the changes need to happen on the front-lines of health care, even as far back as post-secondary education, to provide the necessary knowledge and training to change the attitudes and approaches when it comes to women's health.

'You know your body best'

Lindsay also thinks this change will come with more women standing up for their experiences.

"You know your body best, you know when something's different and changed," she said. "Sometimes we have to push back and question and be a little more insistent about getting some of the investigations that we need."

When MacCaull thinks back to her struggles to have her children, she thinks it could have been her heart.

Now, a mother of three, she is sharing her story and suggests for every woman to be an advocate for their own body.

"Never be embarrassed to go back to the hospital," she said. "I had a physician tell me that he didn't mind being proven wrong, so if symptoms persisted, please come back. And I did, and it saved my life."

On P.E.I., there are an average of more than 120 participants enrolled each year in Health P.E.I.'s cardiac and pulmonary rehabilitation program, which provides education and exercise programs for people diagnosed with heart disease. Approximately 25 to 30 per cent of those participants are women, officials said.

Lindsay Hansen, the program's lead, said one of its goals is to "support women through their heart disease journey while educating the public and other health-care professionals about the importance of early recognition of heart disease and referral to cardiac rehab after diagnosis."