Spontaneous Coronary Artery Dissection

Lucas’ story

November 6, 2015

I am a (recently-turned) 30 year-old man from London living in Singapore. I am in good shape – prior to my incident, I would exercise 5-7 times a week and rowed around the entire coastline of Singapore for charity.

Earlier this year I started a new sport, dragon boating. Essentially it is like canoe paddling but in sprint race form. It is very demanding and the intensity is high.

After one particularly tough training session, I came home, had lunch and felt pain in the middle of my chest. It felt like I had trapped wind, but it would not recede. I went for a walk but then started sweating profusely, so thought I would check in at the hospital to be on the safe side.

Within minutes of an ECG I was told I was having a suspected heart attack. Prior to going to the hospital, I had taken an aspirin for the pain. Quite by fortune, this had thinned my blood to a sufficient extent that enough blood was getting through to my heart. I was rushed through an x-ray and an angiogram, where it was diagnosed that my coronary artery was blocked and a stent was required.

I underwent successful surgery and only then began discussing with the doctor potential causes. He was slightly at a loss because my artery showed no sign of fatty plaque and my cholesterol levels were good. When we discussed how much sport I did (dragon boat x 2 a week, squash x 1 a week, football x 1 a week, weights training/HIT training x 1 a week, and sometimes more) he then asked if I had work-related stress. I had, the day before, resigned from my old law firm because of the stress it was causing me. The workload was fine, but I had an extremely irritating, life-interrupting boss who liked to play his juniors off against each other. He then asked how much I drank; I confess that as an expat I had been drinking far too much, binge drinking at least once a week and drinking 4 or 5 nights a week. He thought it was probably one of or a combination of these three factors, and we left it at that.

On returning for my first follow up, my doctor said that, in fact, he thought that I had suffered a SCAD event. He suspects that the groundwork was laid by excessive drinking, work-related stress and too much strenuous exercise, but the tough dragon boat session in question was the straw that broke the camel’s back. He saw that one of the walls in the artery had torn, blood had leaked in and caused the artery to close up. The scariest words followed: “2mm lower and you would have died”. The doctor recommended buying a lottery ticket that evening, such was his surprise at my survival.

I am almost 2 months on and feel normal. I am on blood thinning and cholesterol-controlling medication for the indefinite future. I have no after effects, or any pain. I am exercising much more moderately, once every two days, and even then only a 40-minute lane swim, a light jog or a light cycle.

The hardest thing is not exercising. Drinking much less has been both welcome and easy. I work at a new law firm with friendly, supportive colleagues and no longer have work stress (to date…). I am very grateful to my doctor for saving my life.

Every session of exercise comes with fear. I have to fight through and push myself each time, because I need to ensure that my heart remains strong and healthy. The toughest thing was seeing my partner afterwards, who looked terrified but was incredibly stoic, and telling my parents over the phone (it is tough for them, not being able to be with me through this process).

My progress has been good. I was supposed to have weekly follow ups for a while, then monthly. After my first weekly follow up, my doctor said progress was so good he was switching me to monthly. After the first monthly, I was switched to three monthly. I have a bit of scarring on one of the heart walls, but it will heal in time. I am cleared to play football again – although only in a “Schweinsteiger”, only-run-when-necessary role as per my Manchester United supporting doctor – but am still waiting for clearance to dragon boating. Part of me thinks pack it in and don’t risk it. But I love it, and don’t want this setback to defeat me. The provisional return date is March 2016, and I cannot wait to be back in the boat with my team mates. I will be terrified from the first stroke onwards, but I want to live my life normally again, within the boundaries recommended by my doctor.

So no matter how healthy you think you are, or whether you are young, this can happen to anyone. And when it does, your whole life changes, and you seriously learn to appreciate the love and care of the important people in it. My prognosis is full recovery and a normal life; I am a very lucky survivor.