SCAD — “Surviving Courageously and Dynamically”: Lisa’s Story
I exercised all the time. I’ve run two marathons and two half marathons and woke up at 4 am every morning to get a workout in before heading to work as a dietitian. As a former exercise physiologist in a cardiac rehabilitation lab, I know how important regular exercise is to heart health.
My husband and I live in the woods of New Hampshire with our three cats. In addition to work, I care for my father, a World War II veteran. His health had been failing and that, among other things, was causing me a great deal of stress. I would wake up 8–10 times each night, with my mind racing.
November 17, 2016, was my father’s 98th birthday. I woke up and went to the gym, which was a daily ritual for me, for my physical health and the added benefit of greatly needed stress reduction. After completing an HIIT (High-Intensity Interval Training) workout, I experienced a pressure in the center of my chest. It felt like indigestion. Since I had no other symptoms, I showered and got ready for work. As I started driving, the pressure grew more intense and I began experiencing pain across my upper back. At that point, it “clicked”. My past experience of 14 years in Cardiac Rehab as an exercise physiologist told me that I was experiencing cardiac symptoms that are classic in women.
Since I was already in the car, I drove 10 minutes to the nearest medical center. An EKG was performed and I was told that I was having a heart attack as medical personnel quickly wheeled me into the catheterization lab while giving me baby aspirin and other drugs. I quickly called my sister, husband, boss and best friends as they were wheeling me in! My catheterization showed the tip of my LAD artery in the apex of my heart was 100% occluded and the branch arteries were also dissected due to a condition called Spontaneous Coronary Artery Dissection (SCAD). SCAD occurs when the inside layer of an artery in the heart tears and instead of blood flowing to the heart, it pools in between the arterial layers, quickly forming a clot that limits or completely stops blood flow to the rest of heart.
The vessel was too small to stent or balloon, so nitroglycerin was injected into the artery which dilated it and immediately resolved my pain. I was admitted to the hospital for observation and to receive medicine to dissolve the clot. I had an echocardiogram which showed an EF (Ejection Fraction) of 65–70% (normal!) and my lipid panel was also normal with my HDL (good cholesterol) high! My peak Troponin (an enzyme that is released when cardiac muscle breaks down after a heart attack) was 2.0, which shows minimal damage during the cardiac event. My coronary arteries were all clean-NO plaque! One of the doctors was amazed and asked me what kind of diet I followed.
The next night I had more pain. My EKGs were abnormal and I was sent yet a second time back to the catheterization lab. The cardiologists were going to try to place a stent as the same artery was 100% occluded again. The vessel was too small as the area is at the bottom of my heart (as arteries move down the tree, they get smaller) so nitroglycerin was injected again and my vessel dilated. That night I had pain off and on, controlled with morphine, nitroglycerin drip and saline solution depending on my blood pressure. My husband and sister were by my side the entire night.
I was allowed to go home after seven days in the hospital but still had intermittent chest pressure. I was told to “chill out” by my doctor and only engage in minimal activity while the artery healed. That meant no exercise until I was pain-free for two weeks. I had to adjust to a very sedentary life of reading, being on the computer, and doing minimal activities around the house (light cooking, folding laundry). It has been difficult to adjust mentally and physically as I am used to going non-stop from 4:00 am wake-up, to the gym, to work, running errands and then doing chores at home.
What bothers me the most is that I cannot move my body the way that I used to. I was in excellent shape and exercised every weekday and took a 10-mile walk every Saturday before my SCAD heart attack. The exercise was my stress management. No matter how much stress I was under or how tired I was, after a workout I always felt better. I have been regularly exercising for over 32 years.
I try to stay strong and positive, but my emotional state is mixed as my SCAD is a recent event. I grieve the “old me” and am trying to find my “new normal”. I have turned the acronym SCAD into my own personal mantra: SCAD: Surviving Courageously And Dynamically. I chose this mantra because I know that I HAVE TO BE POSITIVE moving forward in order to manage stress and to lead a happy life. I am choosing to be brave, positive and I will make any needed changes each day to get better. The positive attitude I am working to adopt will help me to achieve my “new normal” which will include working, exercising, managing my stress. I am appreciating each day I am given and trying not to “sweat the small stuff”.
I requested a consultation with MGH (Mass General Hospital) as the hospital I was admitted to is affiliated with them. One of the cardiologists conferred with a colleague at MGH who suggested that I schedule an appointment at MGH for further workup for FMD (Fibromuscular Dysplasia) a connective tissue disease that is thought to contribute to SCAD heart attacks in some patients.
When I met the SCAD specialist at MGH, she was AMAZING! She sat down with my husband and me for two hours and answered our questions and did not rush us out. She told me the pain I continue to have is probably due to the arteries healing and is quite common in SCAD patients. I am to “chill out” for another month, but can gradually increase my activity level depending on how I feel.
Next month, I will go back to MGH to have a CT Angiogram to look for FMD, aneurysms and to see how well my cardiac arteries are healing. On that same day, I will have a full stress test. If the stress test is negative, I can start Cardiac Rehab. The plan is also to wean me off some of my meds which should also help me feel a lot better.
In addition to the doctor at MGH, I have a great support system and a wonderful Primary Care Physician. I am connected to a Facebook SCAD Survivors page that is a group of brave, supportive women who are very knowledgeable regarding SCAD, its symptoms, and treatment. The one thing that I would like people to know about my SCAD experience is that I realized “it can happen to anyone — even a young, healthy woman with no risk factors for heart disease.” Moving forward, it is my mission to spread awareness about SCAD.
To learn more about SCAD and to find ways that you can help to spread awareness and promote research about this deadly disease, please visit: http://www.scadresearch.org/
SCAD Research Inc. does not endorse one medical professional or facility or treatment over another, please consult with your physician before making decisions about your health.
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