Spontaneous Coronary Artery Dissection

What Now?

August 7, 2014

There I was – on a gurney in the ER: wearing a gown, monitors, IV’s. Less than an hour ago the doctor who had read my EKG from two days ago said that there was an abnormality – an elevated ST level – and that I should go to the ER and get my blood tested…NOW!

“Now?” I asked. I’d just gotten home from a day’s worth of work and had just showered
before he called.


So, there I was – on a gurney awaiting the ambulance that would take me from the medical center to a hospital! “heart attack.” It was no wonder, really. I’d been under an inordinate amount of stress, but I was healthy! I walked 4 miles almost daily, ate well (very little red meat), my cholesterol was normal, and I was doing physical labor at my new job as a part-time housekeeper at an asssisted living facility (my “real” job got outsourced and I needed money to pay for my health insurance)! I even drove myself to the ER! But last week I had chest and arm pain that didn’t really go away. I dismissed it as my usual heartburn until the weekend when i went to a primary care facility to get a chest x-ray and EKG. They had to send out the EKG to get read, but told me that if I was worried it was a heart attack, I should go get bloodwork done at the ER. Nah. The naproxen they prescribed (I had a history of costochondritis) helped me feel better. I’d just started getting over a bad sinus infection so I’d thought I’d blown out the cartilige across my ribcage.

Two days later I went back to work, but was sweating horribly and my so-called heartburn was awful. I ate a handful of antacids and went off to my second part-time job. That was 5 hours earlier. When I arrived at the hospital, they suspected i had pericarditis, but were scheduling me for another EKG and an angiogram the next day. That was when they saw the tear. The day after that I started having horrible chest/arm/back pain that required high doses of a pain killer  to tolerate. They rushed me off to do another angiogram, but only saw that my torn artery was healing by itself. The irony was that my arteries weren’t clogged at all.

The final diagnosis was that I had suffered the “spontaneous coronary artery dissection,” but have the pericarditis, too. One may or may have not caused the other.

I’ve been on medication for the pericarditis and blood pressure medication for my heart. My insurance plan (albeit a helpful one when it came to 4 days in the hospital and two angiograms), does not cover cardiac rehab. I’m still walking and even jogging, trying to eat well – eliminating salt and caffeine, but each day comes with an amount of trepidation; each little chest or arm pain comes with panic. They say that the chance I’ll get another bout of pericarditis is more likely than having another SCAD.

My dad died young (74) from kidney failure, but also had high blood pressure and peripheral vascular disease. My mom had just recently passed away from suspected effects of high blood pressure, but she also had polymyalgia rheumatica (her sister had rheumatoid arthritis). I had just had a uterine cancer scare 4 months earlier and was given a hormone to take for awhile (I’m 55 and childless). I can only surmise that more than half of my physical problems (weaknesses, disorders,…) are genetic. For lack of a better answer to all this, I just try to live one day at a time as stress-free as possible.