Hélène, 26 years old

I’m a resident in my fifth semester and plan to specialize in emergency medicine. Something I recently experienced during a shift in the emergency department led me to do my thesis on coronary syndrome in women. This illness has been on the rise among women for many years. While men receive good treatment, women in 2021 are still victims of delayed diagnosis. That’s because women and men are different and clinical manifestations differ between the sexes.

During my shift, I met Nicole, an 80-year-old woman referred to the fast-track unit for lower back pain. She was an elegant woman and this was her first time in the emergency department.

She told me that three weeks earlier, she had fallen after her foot got caught in her rug. She had fallen on her back and hit her head on the floor. She had some back pain that eventually eased. She hadn’t seen a doctor and had self-medicated with pain medication. But the pain returned and kept her from sleeping. She couldn’t lie down anymore because she felt pressure. The acetaminophen she’d taken a few hours earlier made no difference.

I was curious about the amount of time that occurred between her fall and the current pain, which she seemed to think were connected. I continued my questioning. This woman was very active, invested in nonprofit work and completely independent in her daily life. She did report having high blood pressure and dyslipidemia that were both being treated.

With her symptoms and the existing cardiovascular risk factors, I decided to do an electrocardiogram. It showed some abnormalities that could indicate a heart attack.

Nicole seemed very surprised and said that she didn’t smoke, that it was her husband that smoked and had heart problems. The biological assessment indicated an evolving heart attack.

It had already been three hours since Nicole came into the emergency department, during which her symptoms had continued to evolve. She was admitted for a coronary angiography more than seven hours after symptoms began and it showed that she had acute coronary syndrome. Nicole will continue to have heart contractility issues as a result.

This experience is far from an isolated incident and it made me aware of the insidious symptoms and lack of knowledge among women about their risk for a coronary event, something they still associate too often with men.

That’s why I wanted to build a research project to understand more precisely what characteristics should alert us when a woman comes through the door of the emergency department.

I support Women’s Cardiovascular Healthcare Foundation because of my desire to learn more every day, improve our practices, and research potential symptoms and factors that predict a coronary event in the female population. I hope that my work will promote ideas to strengthen the quality of care for women in our emergency departments.