A Frequent Cause of Heart Attacks in Young Women
April 02, 2020
If you’re a thin, young, non-smoker who exercises regularly, what would you do if you experienced chest pain, nausea and extreme sweating?
No one is too young or too healthy to experience a heart attack. While women are more likely to suffer a heart attack after age 55, it can happen at any age.
One condition, spontaneous coronary artery dissection, (SCAD), causes a small percentage of heart attacks overall, but is responsible for 40 percent of heart attacks in women younger than age 50, according to research from the American Heart Association (AHA). The average SCAD patient is just 42 years old.
Causing Heart Attacks Differently
Typical heart attacks are caused by plaque and a blood clot that blocks a heart artery. But SCAD starts with a tear or bleed in the wall of a heart artery that blocks blood flow to the heart, causing a heart attack.
SCAD patients are generally healthy. They have no or few risk factors like smoking, being overweight or having diabetes. So even if they seek treatment for classic heart attack symptoms, they’re often misdiagnosed with problems like anxiety or indigestion. Misdiagnosis can lead to treatment that may cause more damage.
Symptoms of SCAD include:
- Chest pain or discomfort
- Shortness of breath
- Pain in the shoulders, arms, back, neck or jaw
- Nausea, lightheadedness and sweating
While visiting New Zealand in the summer of 2019, Devorah “Devi” Snively, 49, began having a strange feeling in her upper right chest.
The dull soreness went away overnight, but came back the next day as she hiked. This time she also felt soreness in her jaw and in the back of her neck. Her right arm felt tingly and painful, but the symptoms subsided. Overnight she woke up with that dull soreness in her chest again, but she ignored it as she felt it didn’t seem serious. She was young, thin and fit.
The next day after a workout, she got a migraine and felt lightheaded and nauseous. She vomited for eight hours. Finally, she admitted she needed to go to the hospital.
Tests determined she had a heart attack. She didn’t get much more information in New Zealand, but when she returned to the United States, she found Heather Gornik, MD, a cardiologist with University Hospitals Harrington Heart & Vascular Institute. Dr. Gornik reviewed images from the cardiac catheterization lab taken in New Zealand and discovered what they didn’t: Devi had experienced SCAD, which lead to her heart attack.
Dr. Gornik also diagnosed Devi with fibromuscular dysplasia (FMD). This disease causes cells to grow abnormally in artery walls and is seen in at least half of people with SCAD. Luckily for Devi, she lived through the event and her body healed on its own.
Devi now takes medicine to help prevent another event and completed a cardiac rehabilitation exercise program. Devi plans regular follow-up appointments with her doctor.