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The Uncommon Type of Heart Attack That Kills Healthy, Young Women

As noted in recent news, the symptoms of an uncommon type of heart attack known as spontaneous coronary artery dissection (SCAD)1 is dangerously easy to overlook, as few SCAD patients have any history of or risk factors for heart disease. SCAD is a leading cause of heart attacks in healthy women under 55; the average age of SCAD patients is 42.

ABC News recounts the stories of two women whose sudden heart attacks were triggered by SCAD.2 Five weeks after giving birth to a healthy baby girl, Maryn Cox suddenly developed troubling symptoms. "It felt like pressure, possibly gas; acid reflux, I wasn't sure what it was. One of my arms went numb, I started getting nauseous; cold sweats,” she says. The symptoms, while common, turned out to be SCAD, a condition few have ever heard of.

While SCAD is a cause of heart attack, it’s different from a heart attack caused by coronary artery disease. Essentially, SCAD occurs when the layers of your blood vessel wall tear apart from each other, trapping blood between the layers. As the blood pools and collects between the layers, your blood vessel gets choked off, killing heart muscle tissue downstream from the blockage, thereby triggering a heart attack.

Signs and Symptoms of SCAD

Commonly reported signs and symptoms of SCAD include the following. If you experience these symptoms, call for immediate emergency medical assistance (in the U.S., call 911). It’s important to realize that many who develop SCAD are otherwise quite healthy and most do not have risk factors for heart disease. For this reason, it’s important to seek medical attention if you experience symptoms of SCAD, in order to avoid a lethal heart attack.

Indeed, the No. 1 symptom of a heart attack is sudden death, and the same applies to SCAD. In essence, by the time recognizable symptoms of a heart attack occur, you’re well on your way toward death, so early intervention is crucial.

Lightheadedness

Sweating

Radiating pain in your neck, back or jaw

Shortness of breath

Pain, tightness, pressure or discomfort in your chest (some women report feeling like their bra is suddenly too tight, even though they know it’s not)

Stomach pain

Fatigue

Pain radiating down one or both arms

For whatever reason, SCAD tends to be more common in women — especially younger women, and following pregnancy — although it’s a relatively rare condition overall. While the cause for SCAD is unknown, medical experts have theorized the gender difference may have something to do with hormonal variations. Common risk factors for SCAD include:

  • Being female (80 percent of SCAD patients are women)
  • Recently giving birth (20 percent of SCAD patients have recently given birth)
  • Underlying blood vessel conditions such as fibromuscular dysplasia (a condition that causes abnormal cell growth in the arteries)
  • Extreme physical exercise
  • Severe emotional stress

Best Treatment for SCAD Is Allowing Body to Heal Naturally

Because the underlying cause of SCAD is still unknown, the best course of treatment has been equally uncertain. However, according to a recent scientific statement by Mayo Clinic researchers, SCAD sufferers tend to benefit the most from “conservative treatment, letting the body heal on its own.”3

Dr. Sharonne Hayes, the Mayo Clinic cardiologist who since 2010 has dedicated herself to the study of SCAD (see videos above), says, “It may seem counterintuitive, but we discovered that treating SCAD the same way we treat heart attacks due to atherosclerosis can cause further tearing and damage to the vessel. [T]he initial proper diagnosis is critical in guiding the care."

The Mayo Clinic consensus statement is a significant step forward, providing health care providers with information about how to diagnose and treat SCAD. Importantly, their findings reveal that, in most patients who were not treated with a stent, the dissection in the blood vessel healed on its own within weeks or months.

In some patients, healing began within mere days. The statement also recommends a tailored cardiac rehabilitation program for patients, and stresses the importance of addressing mental health, as anxiety and depression tend to be quite common in SCAD patients.

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