Laura, a 40-year old American heart attack survivor, told me this story of her own cardiac event:
“I was asleep and my symptoms woke me up. I had several simultaneous symptoms, but the first one seemed to be chest pain in the centre-left, somewhat under my left breast area. I’d never felt anything like it, so sometimes it’s hard to describe – it wasn’t sharp or crushing or burning, more like a dull pressure. I also had pain down the inside of my left arm that radiated up into the left side of my jaw and my left ear.
“I was very overheated, and I felt like I was going to throw up. The nausea and overheating faded, but the pain – chest, arm, jaw – stayed. In hospital, I was diagnosed with a heart attack caused by SCAD – spontaneous coronary artery dissection, treated with six stents.”
It used to be, and sadly remains in almost 70% of cases, a deadly condition often only correctly identified post-mortem during autopsy.
This brief animation shows what happens during Spontaneous Coronary Artery Dissection – literally a tear in the wall of a coronary artery, or SCAD as we heart sisters know it.
In women, it’s usually the Left Anterior Descending coronary artery involved; in men, it’s typically the Right Main. The tear can either be ‘primary’, occurring spontaneously out of the blue, or ‘secondary’ as a consequence of undergoing coronary angiography, coronary intervention, cardiac surgery or chest trauma.
I like Laura’s simple yet comprehensive explanation of how SCAD usually happens:
“It’s like when the lining of your favorite coat tears, up near the shoulder, and you accidentally put your arm through the space between the torn lining and the outer layer of fabric, but since the sleeve and lining are still sewn together at the wrist, your arm can’t actually come out where it should, at the end of the sleeve.
“Your trapped arm is like the blood in a dissected coronary artery that can’t get to its destination”
Up to 80% of SCAD cases occur in young healthy women. According to a September 2010 study published online in the Journal of the American College of Cardiology:
“Patients diagnosed with SCAD are characterized by an absence of coronary risk factors, an association with physical or emotional stress, and a high incidence of infarction (heart attack)” .
Spontaneous Coronary Artery Dissection (SCAD) that caused Laura’s heart attack is sometimes referred to as “rare”, but Mayo Clinic cardiologist Dr. Sharonne Hayes now describes this condition as “underdiagnosed” or “infrequent”, especially when discussing heart attacks in younger women. (Mayo Clinic recently saw three SCAD cases in one day, one acute and two as outpatient consultations).
♥ Have you been diagnosed with SCAD? Find out if you are eligible to participate in two new SCAD studies at Mayo Clinic.
♥ Women in Canada diagnosed with Spontaneous Coronary Artery Dissection SCAD are being recruited for a Canadian study based in seven cities nationwide, led by cardiologist Dr. Jaqueline Saw in Vancouver. Ask your cardiologist about participating in the Canadian SCAD Study.
♥ Learn more:
- What is SCAD? written by Mayo Clinic cardiologist Dr. Sharonne Hayes
- WomenHeart online SCAD support community (it’s free to join, and chat with other SCAD survivors from around the world)
- TV News Reporter Jennifer Donelan Survives Heart Attack at Age 36
- in this Wall Street Journal article called “When Patients Band Together: Social Media Spurs Mayo Clinic Research”
- in this very comprehensive article on SCAD from the Netherlands Heart Journal
- Read SCAD Ladies Stand Up: Stories of Patient Empowerment, the special report from Inspire.com and the WomenHeart online support community. It features a number of interesting first-person accounts from SCAD survivors plus an introduction written by cardiologist Dr. Sharonne Hayes called “Traditional Research Methods Turned Upside Down: The Untapped Potential of ‘Patient- Initiated’ Research in the Study of Rare Diseases“ (plus even a link to a Heart Sisters article about SCAD listed on the report’s resource page!)