Procedures performed annually at the Schulich Heart Program, a leader in cardiac care.

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From One Heart to Another

Thanks to a specialized Sunnybrook clinic, Grace Chung is on the road to recovery from an often misunderstood heart condition.

With three kids under the age of seven, Grace Chung is used to some unpredictable bedtime routines. But nothing comes close to the evening in late 2022, when her life changed in an instant.

Walking upstairs, Grace felt her throat tighten. She tried to ignore it, but the tightness began to spread. It got so bad she was having trouble swallowing the small piece of chocolate she had treated herself to after dinner.

Still, Grace tried to brush it off. When her arm began to feel numb, she decided to call 9-1-1.

In the ambulance, the pressure she felt vanished and she found herself doubting her decision, but the paramedics accompanying her were unequivocal: Grace was having a heart attack.

A growing trend

Healthy and with no risk factors, Grace was stunned since her symptoms were nothing like the acutely painful and visceral ones she thought signaled a heart attack. Grace has a medical background herself, having trained in orthotics and prosthetics at Sunnybrook.

Grace was rushed straight to a cath lab at her local hospital and was awake for the entirety of her life-saving procedure, where she could see looks of concern from the specialists around her.

My doctors were shocked by what they saw, saying I was very lucky to be alive. They put in three stents, and told me two out of my three coronary arteries were completely blocked,” says Grace.

Grace Chung
Grace Chung

The team who treated Grace that day undoubtedly saved her life. But even they knew Grace would require more specialized care, which is why they referred her to Sunnybrook – where a groundbreaking donor-supported initiative is helping hundreds of patients and families.

While her story sounds like one in a million, Grace is part of a growing, troubling trend of otherwise healthy women having cardiac events.

Multidisciplinary approach

Launched in 2019, the Schulich Heart Program’s SCAD clinic is a leader in care for cases like Grace’s and many more, working to unravel the mystery of spontaneous coronary artery disease (SCAD) and giving people hope for the future.

The exact cause of SCAD is still unclear, but the Sunnybrook team led by academic interventional cardiologist Dr. Mina Madan is making a meaningful difference thanks to donor support.

“Many otherwise healthy patients are blindsided by the diagnosis of a heart attack at such a young age,” says Dr. Madan, Medical Director of the SCAD clinic.

Dr. Mina Madan

“That’s why we’ve created a multidisciplinary team focusing on educating both future physicians and patients about this condition, as well as patient care and research. Within two to three years, most patients are back at work, enjoying their lives and continuing their SCAD care with their family doctors and community cardiologists.”

Finding new passions

Testing at Sunnybrook revealed Grace has mild fibromuscular dysplasia that weakens the artery walls, a known risk factor for SCAD.

As one of roughly 250 patients at the SCAD clinic at any given time, Grace will continue to receive care for up to three years, with monitoring and advice on how to live with her condition.

Grace still chases after her children Verena, Isaac and Beatrice, but she is also finding new, gentler forms of exercise like badminton with her husband Kevin. She credits her new lease on life to the compassionate care she received.

“When I first arrived at the SCAD clinic, I was so scared, but Dr. Madan and her staff were hugely encouraging and made sure I had everything I needed,” says Grace.

Helping patients like Grace get back to their lives inspires Dr. Madan and her team to continue to raise the bar for patient care, and so much of this work is only made possible by donor support.

Says Dr. Madan: “I am profoundly grateful to our donor community, whose support is vital to helping our patients learn about SCAD and make a full recovery after a life- altering event.”

Offering new HOPE

Donor support is also playing a vital role to expand Sunnybrook’s leadership in renal denervation to treat uncontrolled hypertension, or high blood pressure.

Renal denervation is a minimally invasive technique that targets the renal nerves, located around the renal arteries that supply blood to the kidneys. These nerves help regulate blood pressure by influencing kidney function and the body’s sympathetic nervous system.

An experienced academic interventional cardiologist and Medical Director of the Cardiac Catheterization Lab at Sunnybrook, Dr. Mina Madan is a leader in renal denervation, using fluoroscopic guidance and radiofrequency energy to disrupt signalling of the renal nerves and thereby lower blood pressure.

The impact of the treatment is potentially life changing: It often reduces the amount of medication needed for blood pressure control and other side effects.

Renal denervation also restores quality of life – just ask Dr. David Ellis, a retired otolaryngology surgeon, specializing in Facial Plastic Surgery.

Dr. Ellis was used to working at “100 per cent,” he says, but his worsening high blood pressure was limiting his activities.

Dr. David Ellis
Dr. David Ellis

Referred to Sunnybrook’s interventional hypertension program (HOPE clinic), Dr. Ellis met Dr. Madan, who recommended the unique procedure. It was a success, and now Dr. Ellis enjoys being active again, playing golf and exercising.

“The ongoing care I am receiving from Dr. Madan is perfect and allows me to go about my life. I’m as busy as ever. I can go at 100-per-cent capacity and do things effortlessly,” says Dr. Ellis, who is also a professor at the University of Toronto’s Department of Otolaryngology, Division of Facial Plastic Surgery.

Considering that one in three Canadians living with hypertension have uncontrolled high blood pressure, ongoing donor support for Sunnybrook’s innovative work in this field is urgently needed.
Dr. Ellis is a strong advocate for this procedure, noting that with support, education and training, renal denervation can benefit so many people living with uncontrolled hypertension.

Unique collaboration

In just a few years since its launch, Sunnybrook’s SCAD clinic quickly became a regional referral hub for all of Ontario. Now Dr. Mina Madan is joining forces with Dr. Jennifer Amadio, who leads a new specialized clinic in the Schulich Heart Program.

The Cardio-Obstetrics clinic, launched in 2023, already has more than 100 patients on its roster and is delivering heart care to patients before, during or after pregnancy.

With SCAD being the number one cause of heart attacks in pregnant people, the emerging initiative between the SCAD and the Cardio-Obstetrics clinics sees two high- performing teams coming together to serve more patients.

This collaborative initiative is one of many examples that demonstrates the Schulich Heart Program’s commitment to transforming women’s heart health and care.

“We didn’t have these services before for pregnant patients, and given the size of our DAN Women & Babies Program we needed to establish them. The need for the cardio- obstetrics clinic will only grow, and our partnership will help even more patients and families,” says Dr. Madan.