(P227) REFERRAL SOURCES AND DIAGNOSES IN WOMEN PRESENTING TO A CANADIAN WOMEN'S HEART CLINIC: ADDRESSING A CLINICAL CARE GAP

Background: The establishment of Women’s Heart Clinics/Programs/Centres has been recommended to address key concerns regarding sex- and gender-specific cardiovascular disease presentations, pathophysiology and treatments. The goal is to improve cardiovascular outcomes in women, which have been shown to be less favourable than in men. The QEII Maritime Heart Center Women’s Heart Health Clinic (WHHC) was established in October 2017 to offer focused care for cardiovascular health promotion, disease diagnosis and management in women. The objective of this quality assessment study was to identify trends in the reasons for referral, diagnoses, risk factors, and outcomes of WHHC patients.

METHODS AND RESULTS: Data from October 2017 – December 2022 was extracted from WHHC questionnaires (Patient Intake Tool, HADS score, Godin Scale for physical activity), electronic and paper medical records, then compiled and descriptively analyzed. The Patient Intake Tool assessed symptom presentation, past medical history, family history, cardiovascular risk factors (traditional, sex-specific, sex-more-common), and lifestyle (nutrition, physical activity, substance use, stress). At the time of their initial presentation, patients were requested to provide written informed consent for access to their healthcare data.

A total of 67 women presenting for initial consultation to WHHC had documented consent (of 145 patients presenting; 46%). The average age was 57 years (range 21-85) at the time of referral. 53% of the patients came from urban centres. 95% were from Nova Scotia; 1% New Brunswick; 3% Prince-Edward Island. Referral sources included: family physicians (55%), cardiologists (25%), internists (6%), other/unclassified (14%). The most common referral diagnoses were: SCAD (25%), >3 cardiovascular risk factors (19%), acute coronary syndrome (ACS) at < 55 years of age (18%), and stress cardiomyopathy (3%). HADS anxiety and depression scores (mean + SD) were 6.09 + 3.82 and 5.29 + 3.41. Godin results for weekly activity time (mean + SD) was 44.55 minutes + 123.9.

Conclusion: Women attending the WWHC at the QEII Maritime Heart Center present from both urban and rural Nova Scotia upon referral by family physicians and cardiologists for assessment of SCAD, ACS ( < 55 years), and management of cardiovascular risk factors. Depression and anxiety were not found to be overrepresented in this population, however physical activity was lower than the guideline recommendations. Next steps include development of a national multicenter registry to analyze impact of focused specialized cardiovascular care clinics for women in order to better understand and serve the needs of women at risk for and living with heart disease across Canada.