Spontaneous Coronary Artery Dissection

That Friday in May

October 15, 2015

On Friday 22nd May 2015, I had a heart attack. I had woken that Friday morning with a deep ache just behind my left shoulder blade that rapidly turned into a sharp piercing pain. I thought it was due to falling asleep on our couch the night before – our family nickname for our feather couch is ‘the back-breaker’ and that’s what I attributed the pain to. Interestingly I had been unwell all week with a vicious stomach bug and had spent the early hours of the Monday into the late afternoon being violently sick. It had wiped me out for days and I had only returned to work on the Thursday.

Other threads in this story are that for the last two years I had been struggling with menstrual aches and cramps – feeling anxious in the middle of the night and having stomach bloating. I had been diagnosed with Adenomyosis and had discussed the possibility of a hysterectomy. I also had experienced stress – both my parents lived over 200 miles away and my Dad had been diagnosed with cancer and had to undergo extensive surgery. He came out of hospital and within a week my mum fell and broke her hip, was diagnosed with an enlarged heart and tragically passed away within 14 months of breaking her hip. I run a successful business and the year my lovely mum died coincided with quite extensive challenges at work – these were overcome but I do think that all of these events played a role in my poor health. I had experienced chest pain two or three times during this time and taken myself to Accident and Emergency -an ECG was performed on me and bloods taken but all readings came back as normal . I was told my chest pains were due to my bra being too tight and being peri-menopausal.

Anyway when I woke that Friday morning I was not surprised to feel unwell as I had got used to not feeling great and I honestly thought the pain was a trapped nerve. I got dressed and tried breathing through the pain -my husband offered to massage the pain but his touch just made me feel sick – it reminded me of being in labour when you just can’t get comfortable no matter what you or your partner does to help. The pain got stronger and moved into my jaw. I wandered around – went outside to see if fresh air would help – sat in my daughters room with the window open. My chest felt tight by now and I said to my husband that I thought I was having a heart attack. He said of course I wasn’t and I thought of course I am not!

I am 51, a vegetarian for 30 years, don’t smoke, have normal-low blood pressure and low cholesterol. I am slim and pretty fit. I remember thinking bloody hell I don’t believe it but I am having a panick attack. I went upstairs to try and lie down but could not get comfortable – everything hurt and I was scared-very scared. I tried getting on all fours but that hurt too. By now I was breathing rapidly and shallowly and I said to my husband I think I need help here- I think I need an ambulance. He took one look at me and said that he would take me to the hospital. Thankfully he insisted on taking me to Wythenshawe rather than the closer community hospital – it turned out its the best heart centre in the North West of England!

On the way there my left arm went numb then began to tingle and I developed pins and needles in my hand and fingers. That’s when I knew I was having a heart attack. Then the right arm started. To cut a long story short I was seen straight away and within minutes was given an ECG which confirmed that I was having a heart attack, and whisked to the Cath lab. Apparently they attempted to open the blocked artery ( my right artery) with the balloon but the blockage wouldn’t dissipate and so a stent was inserted to open the artery which had a 99% occlusion.

On my notes it mention a dissection but when the doctors came to see me on the ICU they didn’t mention the dissection at all. I asked them what had caused it and the consultant on duty said it was CAD – plaque build up and I would have to be on a cocktail of medication including Statins. I couldn’t make sense of it at all – I had none of the risk factors at all!! After discharge and in the following weeks I continued to experience pinching pains in my chest and painful stomach cramps and muscle cramps in my arms and legs.

I came off the statins as my cholesterol was naturally very low and I felt the drugs were making me worse! Eventually I managed to get an appointment with my cardiologist and told him I couldn’t understand why or how I could have CAD. Thankfully he listened to me and went to see the surgeon who had performed the procedure. A couple of weeks later he wrote to my GP to say that on meeting me and looking at my angiogram and talking with the surgeon it was clear that what I had experienced was a SCAD.

Now I am just waiting for results of blood tests for connective tissue disease. They have not tested for FMD though – I think that in most hospitals in the UK they don’t really test thoroughly for SCAD and I am left feeling a bit uncertain about what could happen next. Have signed up for the Leicester University research so that should be good.