Spontaneous coronary artery dissection, or SCAD, is the condition responsible for 40 per cent of heart attacks in women under 50.
More than 90 per cent of SCAD patients are female.
The usual risk factors for heart attack – overweight, smoking, bad diet, diabetes – are not seen in SCAD patients.
Why? Because, unlike regular heart attacks, SCAD is not caused by a buildup of plaque in the arteries. Instead, it’s caused by a tear in an artery, which blocks blood flow to the heart and can result in a heart attack.
“SCAD is happening to a group of women who appear healthy, are thin, and have no risk factors. So even though they have classic heart attack symptoms, they are often being misdiagnosed,” Sharonne Hayes, of the Mayo Clinic in Minnesota, told Web MD.
Diagnosis is different with SCAD, than it is with regular heart attacks. Typically, you can detect a heart attack through blood work or an electrocardiogram. SCAD, on the other hand, can only be detected with an angiogram, which uses X-rays and a special dye to take pictures of the arteries in your heart.
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As well as being misdiagnosed, young women SCAD sufferers are likely to wait, and wait, and wait before even presenting to a doctor or hospital.
A 2015 study from the Yale School of Public Health looked into the experiences of women under 55 who’ve been hospitalised for a heart attack.
The researchers found it’s common for younger women to “ignore” or “dismiss” the signs of a heart attack. They’re more likely to delay seeking care, due to anxiety about raising a false alarm and usually rationalising that they’re “too young” to have heart problems.
So, what are the signs?
One woman, Meghan Scheiber, who was 33 at the time of her heart attack, told Web MD the sensation was sudden. She was at work at the time and, without warning, she felt like she was going to pass out. She had a heavy feeling in her chest and arms. She originally put it down to an anxiety attack or the beginning of the flu. It wasn’t until she suffered the same sensation the following day at home, that she knew she needed help. “I said to my husband, ‘We have to go to the ER,” Scheiber said.
When she arrived at the hospital, she was in the middle of a heart attack. “I asked my doctor if I would die,” she recalls, now six years later. “He said he didn’t know what would happen.”
The typical symptoms of a heart attack could all apply. They might not all occur at once, but it’s important to be informed.
- Pain in the neck, back or jaw
- Chest pain or discomfort
- Nausea or stomach pain
- Limb fatigue
- Shortness of breath
- Pain in your arms
Who is most at risk?
The average SCAD patient is 42 years old.
As well as this, women can be at higher risk around childbirth with 10-15 per cent of SCAD cases happening in this period. Doctors suggest there might be a specific hormonal explanation because SCAD occurs with both cesareans and vaginal deliveries.
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Thankfully, the mortality rate of SCAD heart attacks is comparatively low. The death rate ranged between one and five per cent. However, chances for a repeat SCAD attack are high and a second attack will occur in 20 per cent of cases.
Treatment is possible with a combination of blood-thinning and anti-platelet medication. Patients are also given education around heart health and exercise.
The most important step, however?
To get to the hospital. Know the signs and take action. Don’t dismiss nausea or pain or light-headedness, and don’t be scared of making a fuss. Heart attacks can occur in young women. Don’t “rationalise” yourself into greater danger. When in doubt, always seek help.