Spontaneous Coronary Artery Dissection

Close Call After Exercise

October 28, 2018

I am an otherwise very healthy 51 year old male that exercises regularly and eats well most of the time. My exercise routine had been pretty intense and consisted of about 2 hours of continuous exercise 3 days per week. My day started with a small cup of coffee and a Clif Bar as I went to the gym at 4:30 AM. I would do pretty intense weight training for about 1 hour and transition to either 30 minutes on the stair climber or a 1.5-2 mile run. I would then return back to weights for about 30 minutes to finish out. It was not unusual to feel a bit weak and feel a little nausea as I finished up, but that generally cleared up by the time I finished the shower and got dressed.

On September 19th, I had the typical workout day and headed for work from the gym. I called my wife and told her that the nausea had not subsided and that I was feeling a little rough. About 2.5 hours later at work, I had transitioned from a nausea feeling to an intense heartburn feeling. I was used to the feeling because sometimes coffee without food will give me a little heartburn. However on this day, it got worse. I asked my secretary for some Tums and took several. I went back to my office for about 15 minutes and decided my heartburn was still getting worse.

I made the decision to go to a nearby ER and have an expert confirm for me that it was just heartburn. The folks at the ER started my on a standard heart attack protocol and drew blood and an EKG. Both came back normal, but my blood pressure was 165 over 90, and I had never experienced seeing it about 140, even on a bad day. It stayed in the 160s for a couple of hours, then dropped back into the 130s. I had told the clinic staff that I had a post surgical blood clot a few years back after a hip surgery and I was administered some Heprin, which may have saved my life. At the 3 hour mark, the doctor completed a second blood test and identified that the enzyme Triponin was elevated, indicating my heart was in distress. I was transferred to a local hospital and taken straight to the cath lab. The cardiologist quickly found a tear in my left anterior descending (LAD) coronary artery just outside the heart. The tear had formed a clot and had nearly blocked all blood flow. The cardiologist was able to remove the clot and put in a stent where the tear was identified. The doctor leaned over me on the table and told me that I was very fortunate. Had I stayed at work, I would have had a massive heart attack in my office and would not have survived.

Nine days later I was able to take a stress test and visit with the doctor. He told me that I had experienced SCAD and it was likely caused by the intense isometric exercise. I had no plaque and no signs of artery disease. Due to the quick intervention, I did not suffer any heart damage. I was told to reduce the intensity of my exercise and was given a full release with a long-term prescription to help my body manage the stent.

I was totally unaware that SCAD could occur. I am yet to meet anyone outside of the cardiologist that has heard of it. There needs to be more public education and awareness. I lost a co-worker many years ago who was also very fit and exercised intensely on a regular basis. When he died of a massive heart attack, it was a shock to all of us who knew him. I now wonder if SCAD could have been the culprit.