Spontaneous Coronary Artery Dissection

From surgeon to patient

June 23, 2020

Hi, I’m a physician and eye surgeon living in Orange County, CA. Two weeks ago, I celebrated my 40th birthday. I didn’t feel over the hill. I was running 20+ miles per day and I still haven’t grown my first gray hair. I eat a healthy pescatarian diet (vegetarian diet plus seafood), I have no major health issues so what came next threw us all for a loop.

Nine days after turning 40, I had a heart attack. I had just completed one of my marathon runs (still trying to prove to myself that 40 is the new 30) and I was home alone when I developed a heavy sensation in my chest. It felt more like pressure than pain, but my arms, especially my left, became extremely painful and eventually numb. It was intense, hard to breath and I felt like I was going to vomit. As I crawled to the bathroom I caught a glimpse of myself in the mirror. I saw a sweating ghost that I could hardly recognize as my own reflection.

I am so grateful for my medical training. I knew these were the classic symptoms of a heart attack and although I didn’t have any risk factors or previous heart disease and am relatively young, I knew I had to act fast. Somehow I summoned the strength to get to the phone and call for help. If I had waited to see if it would pass, who knows how much longer I would have lasted, especially if I passed out. So rescue came and EKG showed ST elevation which is a strong indicator of a heart attack. The paramedics weren’t convinced however. They told me it was probably nothing, but it would be a good idea to go get checked out in the hospital. Throughout the ambulance ride, they continued to reassure me that my vital signs were just fine. My heart rate and blood pressure were in normal range. But I knew that the pain I was experiencing was not normal.

In the ER, I had to go through a battery of questions about my health, my symptoms, my history. I tried very hard to stay calm because I’m well aware that my presentation was characteristic of a panic attack and I could tell that’s what they were thinking. In a way, I guess I was lucky that it was a large heart attack because my cardiac enzymes came back very elevated which meant I went straight to the cath lab, where they could see that I had suffered a very rare condition called a spontaneous coronary artery dissection (SCAD). It’s a break in the inner lining of the vessel wall which allows blood to fill up, clot and block off the artery. The treatment choices were stenting the vessel or coronary bypass surgery. Within two hours, my chest wall was open, my lungs and heart were operating on a pump and my wonderful surgeon was grafting my mammary artery onto my heart. Although I’ve spent countless hours in the hospital as a medical student, intern, resident and now surgeon, this whole experience was from a completely new vantage point. My recovery was rapid, probably because I was in good shape before, but also I think that the excitement I derived from my plan to start living my best life brought me extra energy.

Most people don’t experience a life threatening event until they are much more advanced in age. I actually think I’m lucky to have had this happen so young. Now I can start implementing changes geared towards living the happiest and healthiest life. And I’ll have so many extra years to experience these changes.

The other major motivating factor for me is that I would like to start spreading the word about heart disease in women. More women die from heart disease than breast cancer, and yet the majority of diagnoses and surgeries are performed on men. And 60% of SCAD events are not discovered until autopsy. This needs to change and I’m going to do everything I can to bring awareness to this issue.

Additionally, I’m a bit of a health nut. I’ve always embraced a healthy diet and probably a bit too much exercise. Now, I want to take a more scientific approach to healthy living. My medical background helps, but there is so much they fail to teach us in medical school about diet and exercise. So as I educate myself, I plan to share what the science says along with my personal experience. That’s about it for now. Oh just one more thing, please don’t wait for an event like this to start living your best life. We all have it in our power to make changes now, and if you’re interested I’ll be here to help you on your journey as I proceed with mine. Bye for now!