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Don’t trust your heart health to your wearable device

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Illustration by Catherine Chan

It’s embarrassing to admit that despite my years advocating for women’s rights, I recently failed an assertiveness test with life-threatening consequences.

I blame arrogance-fuelled denial.

While sipping a bowl of soup at home, in the space of 60 seconds, I went from perfectly fine to wretched. Drenched in marathon-runner sweat, and battling next-level nausea, I also had a strange inclination to saw off my aching left arm.

It wasn’t the absence of chest pains that had me lean over the toilet bowl, hoping that if I just threw up, I’d feel better. It was my certainty that 40 years of eating a largely vegetarian diet, never smoking and maintaining an exercise regime that had kept my weight pretty much the same my entire adult life, would protect me.

Besides, my Fitbit, which I consulted daily, regularly assured me I was in “excellent cardio health”!

But the inexplicably sore arm and excessive sweat were concerning. So while leaning over the toilet, I asked my husband to consult Dr. Google. His search for “heart attack symptoms, women” delivered an alarming list that mirrored my own. I chewed an Aspirin as advised and he drove me to the nearby urgent care centre.

This is where my three decades of assertiveness as a long-time women’s advocate failed me. Because once there, I stood in line behind seven other people with sprained ankles and bad coughs. (Actually, feeling too weak to stand, I waited my turn in a handy wheelchair instead.)

The doctor who eventually looked at the blood results confirming the severity of my situation was not impressed by my hesitancy.

In my memory, she practically shouted the words, “You’ve had a heart attack!” That’s what it took for her to puncture my belief that my low heart rate, clear echocardiogram and decades of clean living meant there was “nothing to see here.”

To be fair, the first cardiologist to review my chart confessed he, too, was “mystified” by my case. And within 24 hours, I felt 95 per cent better. But the hospital kept me in the cardiac unit for four days, chained to the bed by a raft of monitors that woke me up every time my heart rate dipped below 50.

To shed light on my puzzling symptoms, the doctors also sent me by ambulance to another hospital across town for a diagnostic test. The attendant riding with me asked, “Are you worried about the angiogram?”

The concern in his voice caused me to confess that I hadn’t known enough to realize I should be. But an hour later, watching on a computer monitor as a masked doctor in scrubs vigorously manipulated my wrist like a Game Boy to send the catheter up through my arm toward my heart, it all became clear: one wrong move and that catheter could poke a hole in the sensitive system that was keeping me alive.

The imaging test, confirmed the following day by a CT scan, solved the mystery: my diet and exercise regime had, indeed, protected me from heart disease. What I’d had was not a heart attack, but something I’d never heard of – a spontaneous coronary artery dissection, or SCAD.

Chances are you’ve never heard of it either. And one of the reasons for that is the people who most often experience this tear in one of the arteries encircling their heart are women. Usually younger, healthy, often very fit women. Sometimes women who are pregnant or have just given birth.

The good news is, your arteries have three layers, and so an internal tear isn’t as dire as it might sound; it usually heals in a month or so.

But there’s no cure for the underlying rare condition that often causes the tears. Called fibromuscular dysplasia (FMD), it causes some of your arteries to stiffen, making them weaker and more vulnerable. FMD is similarly understudied, and yes, more prevalent in women.

Although personally frustrating, this could be professionally useful for me: The non-profit I run advocates for the importance of incorporating women’s experiences and insights into every important conversation we have in this country – health care research included.

In the meantime, I’m fine. All this drama happened in December on the eve of a long weekend my husband and I had planned in the mountains. (Impeccable timing: my schedule was free!)

But the Aspirin I’m now encouraged to carry with me wherever I go has made me a little more carpe diem than I used to be.

Knowing how many women absorb cultural messages about putting others’ needs ahead of their own, I’m here to remind all women – whether or not they’re new mothers, devoted to daily exercise or only intermittently assertive: Your Fitbit is not diagnostic, and your friends and family want you alive.

Until the research around women’s health improves and we know more about our unique risk factors, don’t let your reluctance to jump the queue or demand to be seen, threaten your survival.

Shari Graydon lives in Calgary.

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