Spontaneous Coronary Artery Dissection

Long Journey to Diagnosis

January 20, 2015

I had run a 15K race on November 9; ran at a moderate pace, but I was tired and somewhat dehydrated so it was a little tougher than an ordinary weekend run. No symptoms during the race or while hanging out with friends afterward or on the drive home. As soon as I started walking from the car to the house (about 2-1/2 hours post race) I felt tightness in a band across my chest, experienced shortness of breath and light headedness. I stretched out on a bed and began to get fairly severe chills – at which point my wife got me to the car and took me to the local ER. Slow but steady recovery there, with everything appearing normal 1+ hours post incident, but troponin levels were elevating so I was transported to a large regional medical center where I was admitted.

Tests showed troponin continued to rise to 1.36 before leveling off and beginning to decline. Stress test done the next morning was normal. EKGs normal. No family history of heart disease. I’m in pretty good shape. Conclusion of the attending cardiologist was that I had not had a heart attack, but he ordered a chemical stress test to get a better picture of the heart. Had that done and was told the results were normal. I had, however, been talking with and sending all medical records to a long-time friend who is a cardiologist in another city. He and his colleagues were convinced I had had a heart attack and needed a cardiac catheterization. I was fortunate that he and another friend from my youth (who works in their cariac cath lab) were able to get me in within a few days. So off I went and the results were immediate and clear: SCAD that had led to a heart attack. Currently being treated with medication to facilitate healing and seeing another colleague of my friend for follow-up.

Concern, of course, is that I could easily have taken the “easy” route and accepted the diagnosis of the initial cardiologist I saw at the regional medical center – and gone on, having had a significant heart attack, not knowing and not receiving proper treatment. And beyond that the outcome is just rather frightening speculation. So I will do what I can to try to spread the word – while taking care of myself!