A new definition of heart attack could transform care for women

For decades, the way heart attacks have been defined and diagnosed has unintentionally prioritised the patterns most commonly seen in men. A landmark new global definition could finally begin to change that.

The world’s leading cardiovascular organisations have agreed on a new universal framework for diagnosing heart attacks. The guidance recognises causes that disproportionately affect women and introduces sex-specific thresholds for troponin, a protein released into the blood when the heart is damaged.

Previously, women were often assessed against the same troponin threshold as men. Because women can experience heart damage at lower levels, this approach risked heart attacks being missed, diagnosed late or treated less urgently.

The updated definition also gives greater recognition to three causes of heart attack that are more common in women:

• Coronary artery spasm, where an artery suddenly tightens and restricts blood flow

• Coronary embolism, where a clot or other material travels to and blocks a coronary artery

• Spontaneous coronary artery dissection (SCAD), caused by a tear in the artery wall

SCAD is particularly significant for women, who account for around 80% of cases. It can occur during or shortly after pregnancy and may affect people without the traditional risk factors associated with heart disease.

These heart attacks do not always involve the familiar image of an artery blocked by plaque. As a result, women experiencing them have historically been more likely to be overlooked or receive treatment that does not address the underlying cause.

The new framework is an important reminder that healthcare cannot be truly universal when the male body remains the default. Better definitions shape better research, testing, diagnosis and treatment. They also give women clearer answers about what happened to their bodies and what care they need next.

This is exactly why Ovum exists. By helping women bring the full context of their health together over time, Ovum supports them to recognise changes, prepare for appointments and advocate for care that considers the whole picture.

Ovum is also helping build a diverse longitudinal women’s health dataset to address the historic lack of data behind the gender health gap and contribute to a future where women are better represented, understood and believed.

If you think you may be experiencing a heart attack, call Triple Zero (000) immediately. Do not wait for symptoms to worsen.

Sources: The Guardian and the European Society of Cardiology.