N07 — February 2013 — Hidden Heart Attack

Intro: A heart attack at age 35. That's not supposed to happen. The woman you're about to meet suffered what's called a spontaneous coronary artery dissection, or SCAD. It's a condition that's hard to diagnose and there's very little information available about it. Experts at Mayo Clinic have results from studies aimed at learning more about this life-threatening condition.

"I could have died from this."

Ana [Ah'-nah] Gregg rushed to the E.D. with symptoms of a heart attack.

"Stabbing pain in my chest."

She went home without a diagnosis.

"I was told it was acid reflux. I took some Tums, some Tylenol for pain. Went home and slept it off."

Months later, it happened again.

"I couldn't believe it I was in tears. This couldn't be happening to me."

What happened to Ana was not a typical heart attack. Her doctor told her she suffered a spontaneous coronary artery dissection, or SCAD.

"He gave me a sheet of info that was a tiny paragraph that said here's what SCAD is and we don't know much about it."

"It's when, instead of a plaque building up, the artery splits."

Mayo Clinic Dr. Sharonne Hayes is one of the first doctors to research this uncommon condition, which happens mostly to young women. A tear develops on the inside of a coronary artery, allowing blood to create a split between two layers of the wall. This may result in a loose "flap" of tissue on the inside of the artery. Sometimes the split remains small, but the blood in between the layers can clot, this clot called an intramural hematoma may cause the normal artery channel to become narrow, blocking blood flow to the heart.

Dr. Hayes' research, published in the journal Circulation, reveals new information about this condition. First, angiograms, which help visualize arteries, could make the problem worse by lengthening the tear, so additional imaging techniques should be considered.

Second, her data shows SCAD patients had a higher than expected rate of having an artery condition called fibro muscular dysplasia, which could increase the risk of SCAD. Third, she found recurrence is not as rare as once thought.

After having seven stents placed to keep her arteries open, Ana is grateful for every second with her boys.

Every day I think God's given me a new day with my kids, with my husband.

For Mayo Clinic News Network, I'm Vivien Williams.

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Dr. Hayes is founder of Mayo Clinic's Women's Heart Clinic. With her colleagues, she has launched studies to develop a registry of SCAD patients and a bio bank where DNA and other samples can be stored for future research.

Dr. Hayes says all people who've had a SCAD should have regular check-ups with a cardiologist, because they may be at risk of it happening again.

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