Julain Molnar did not believe she was a candidate for heart disease.
A former dancer, the 54-year-old Stratford woman has long enjoyed an active, healthy lifestyle.
She describes herself as a plant-based eater that is roughly 98 per cent vegan.
After lunch one day almost two years ago, Molnar experienced radiating chest pressure and slight pain.
“It could have been indigestion,’’ she recalls.
“That’s what it felt like – except it sort of didn’t.’’
She chose to err on the side of caution. She went to the hospital.
While waiting for test results, a doctor believed Molnar was likely indeed simply experiencing indigestion.
Far from the case.
Molnar’s troponin levels were elevated and her EKG was slightly irregular. She was admitted to hospital where she had another episode.
She went to Halifax for additional tests eight days later and, after much discussion and some uncertainty, it was decided that she most likely had spontaneous coronary artery dissection (SCAD).
By the numbers
Women are 10 times more likely to die from heart disease, stroke and related vascular conditions than from breast cancer.
Heart attacks are more deadly for women, and women are more likely to suffer a second heart attack than men. Pregnancy, menopause and hormonal changes affect women’s risk.
Eighty-eight per cent of spontaneous coronary artery dissection (SCAD) patients are women, many young and otherwise healthy. SCAD is the most common cause of pregnancy-associated heart attacks.
Source: Heart and Stroke
Julain Molnar of Stratford says her unsettling incident of spontaneous coronary artery dissection (SCAD) in 2018 initially felt like indigestion but at the same time felt alarming enough to have her make the right decision to head to the hospital. JIM DAY/THE GUARDIAN
SCAD is a potentially fatal condition where the heart’s artery walls start tearing apart. Eighty-eight per cent of SCAD patients are women, many young and otherwise healthy.
In most cases, as was the case with Molnar, women have no traditional risk factors for heart disease and no warning signs. And when it happens, SCAD is often under-diagnosed because it can be difficult to detect on traditional angiograms.
After many appointments, drugs and lots of research, Molnar’s SCAD seemed to point to large amounts of migraine medication that she had taken for 15 years.
She had been prescribed migraine medication, which caused the lining of her arteries to contract. She was taking a lot more than the recommended dose per month and was unaware of the danger.
She has since drastically reduced her pain medication and has gone through four months of cardiac rehab that, she said, provided “incredible support’’ and valuable information.
“To be in a room full of people who have experienced something similar to you and to talk about it, it was very emotional,’’ she says.
Molnar is telling her story as a cautionary tale to other women.
“Consider yourself a candidate (for SCAD) no matter what – and I don’t mean be scared,’’ she says.
“I mean educate yourself …. (Women) need to know what’s possible and how to prevent it from happening or if it happens they need to go right away (to the hospital).’’
Molnar feels she is doing everything in her power to remain healthy and to prevent – or be well prepared for – another SCAD incident.
“I think the best thing to do going forward is to trust that I live a healthy lifestyle…and to trust that I know the symptoms,’’ she says.
“By investing in research focused on women, we are gaining the knowledge to save more lives and create better outcomes. But much remains to be done. Women are still paying too high a price for gaps in research, prevention, diagnosis and treatment.’’
Signs of SCAD
If you experience an episode of spontaneous coronary artery dissection (SCAD), you may have any of these symptoms:
Chest pain, pressure, tightness or heaviness
Rapid heartbeat, fluttery feeling
Pain in arms, shoulders, jaw, neck, back or stomach
Excessive sweating
Unusual/extreme exhaustion
Nausea, vomiting
Dizziness/lightheadedness
Fainting/loss of consciousness
Headache
Source: Heart and Stroke
Dr. Jacqueline Saw, a leading expert on spontaneous coronary artery dissection (SCAD), says she has seen “horror stories’’ of women in their 30s and 40s turned away from the ER despite heart attack symptoms.
Saw has developed a way of helping doctors detect SCAD, and with support from Heart and Stroke, her team has identified genes that increase the risk of SCAD. Within the next five years, she expects to see genetic screening tools, much better rates of diagnosis and better treatment protocols.
The new Heart and Stroke report, released Thursday, shows funding for research on women is yielding results.
The report, called Spotlight on Women: A fighting chance, focuses on the stories of three women with life-threatening diagnoses and how new research can transform their lives as they face sex and gender challenges.
Biological differences
Anne Simard, chief mission and research officer with Heart and Stroke, notes there are real biological differences between the sexes.
“Women’s hearts are smaller, with smaller coronary arteries, and plaque builds up in their blood vessels differently,’’ she says.
“By investing in research focused on women, we are gaining the knowledge to save more lives and create better outcomes.
“But much remains to be done,’’ adds Simard. “Women are still paying too high a price for gaps in research, prevention, diagnosis and treatment.’’
The Heart and Stroke Foundation of Canada was rebranded as simply Heart and Stroke in late 2016. Heart and Stroke is a charity dedicated to advocacy, education and the funding of research surrounding heart disease and stroke.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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