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Sarah.theheartdoc

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Sarah.theheartdoc

Mum of 2, wife, heart doctor, enthusiastic optimist. Women in Cardiology Representative & founder of

20/10/2026

Are women different to men?

What if the answer is NO?

What if we treat women as we treat men? Would we save thousands of lives?

When a woman has a heart attack she is:
- not getting an ESC as quick
- less likely to be taken to the cath lab
- less likely to receive optimal medical therapy

Biological difference doesn’t even come into this?

Let’s make the unconscious bias CONSCIOUS!

What are your thoughts?

Thank you for the invitation to speak about cardiovascular care in women.

Great to meet the rest of the team

Follow .theheartdoc for more and have a listen to BEATWISE the podcast on all podcast platforms

♥️

15/10/2026

I’m a cardiologist, and that comes with a responsibility to be careful about what I share here.

There’s plenty of heart health advice online. Some of it is useful and some leaves you more confused than you were before.

I want to explain what we know and be honest when there isn’t a straightforward answer.

It’s also why I started my podcast, Beatwise so you can hear from the experts and understand how the research relates to your own health.

And hopefully feel a little more comfortable asking questions at your next appointment 🫀

09/10/2026

A heart failure diagnosis should be the beginning of the investigation, not the end.

But what does good heart failure care actually look like, and how do we ensure patients receive the treatments and support they need?

In episode 55 of Beatwise The Podcast, I’m joined by Becky Hyland, heart failure nurse and Chair of the British Society for Heart Failure Nurse Forum, to discuss what the latest ESC heart failure guidance means for patients and healthcare professionals in the UK.

We discuss the importance of earlier diagnosis, understanding the underlying cause of heart failure, and ensuring patients can access evidence-based treatments.

We also discuss some of the challenges facing heart failure services, including workforce pressures, medication monitoring, specialist referrals and continuity of care.

Because having guidelines is one thing but putting them into practice is another.

And ultimately, improving heart failure care requires more than prescribing the right medication. It requires communication, collaboration and involving patients in decisions about their treatment.

🎙️ Episode 55: Heart Failure: What the New ESC Guidelines Mean for Your Care is available now on Beatwise The Podcast.

Listen on Spotify, Apple Podcasts or your preferred podcast platform.

02/10/2026

Should we refer older, frail patients with suspected cardiac amyloidosis?

Multifactorial breathlessness creates a diagnostic trap. Anaemia, CKD, HFpEF, atrial fibrillation and deconditioning may each explain part of the presentation, while the wider ATTR-CM pattern remains unrecognised.
This Friday, Angelique Smit and I will use a case-based discussion to explore:
• when multimorbidity should increase rather than reduce suspicion of ATTR-CM • whether ATTR-related disability can look like frailty • what a practical frailty assessment adds • why comorbidity alone should not determine referral or treatment • how specialist assessment supports shared decision-making

Join us at the 21st Annual Scientific Meeting of the Cardiorenal Forum.
Friday 2 October 2026 15:05 The King’s Fund, London
“Anaemia, breathlessness, cardiomegaly… and the multimorbid amyloid patient”
Dr Sarah Birkhoelzer and Ms Angelique Smit

Programme and registration: https://cardiorenalforum.com/CRF-ASM-programme-2026.php

For healthcare professionals. The case shown is fictional and intended for education.

01/10/2026

ATTR cardiac amyloidosis is diagnosed far more often in men.

But does that mean it is genuinely much less common in women or could some women be going unrecognised for longer?

Women with ATTR-CM are typically older at diagnosis and may already carry a diagnosis of heart failure with preserved ejection fraction (HFpEF). Because women generally have smaller hearts, they can also show less absolute wall thickening than men, despite clinically significant disease.

This matters when a single wall-thickness threshold is used to raise suspicion in everyone.

In a recent single-centre study of 240 patients with ATTR-CM, women experienced a significantly longer median diagnostic delay than men: 750 days compared with 86 days.

However, only 34 of the patients were women, so larger prospective studies are still needed.

The answer is not to diagnose amyloidosis from one symptom or scan measurement. It is to consider the complete pattern: symptoms, medical history, cardiac imaging, biomarkers and extracardiac clues.

On Friday 2 October, I’ll be speaking about women and amyloid at the Cardiorenal Forum - exploring what we know, where the gaps remain and why sex-specific differences deserve closer attention.

Save this as a reminder that cardiac amyloidosis does not only affect men.
References:
Aimo A et al. S*x differences in transthyretin cardiac amyloidosis. Heart Fail Rev. 2024;29(2):321–330. doi:10.1007/s10741-023-10339-w.
Bruno M et al. Transthyretin amyloid cardiomyopathy in women: frequency, characteristics and diagnostic challenges. Heart Fail Rev. 2021;26:35–45.
Vogel J et al. S*x-specific differences in cardiac transthyretin amyloidosis. Eur Heart J Open. 2026;6(1):oeaf175.

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