Liza Stearn, 44, was viewing a house for sale when she suddenly felt faint, broke out in a cold sweat and experienced a sharp, numbing pain down her left arm. Thankfully, her husband ignored her request not to call an ambulance. Within minutes of the ambulance arriving, the active mother of two children, aged three and seven, went into cardiac arrest and had no pulse or heartbeat. “I had always lived an energetic, outdoors kind of lifestyle, which involved traveling, running, swimming, kayaking and camping,” the travel and sales consultant from Sydney, Australia explains. “Now I was fighting for my life.”
Her husband watched on in horror as paramedics administered CPR, medication and seven defibrillation shocks. The 41-year-old was rushed to the hospital in Sydney and her family and friends were grief-stricken, as they waited to see if she would pull through.
Luckily after five days in a coma, she awoke with no brain damage. “I then spent six weeks in the hospital and had another heart attack,” says Stearn. “I felt shocked, fearful, overwhelmed and devastated to learn I had a rare heart condition that could kill me.”
Tests showed that Stearn had suffered an uncommon heart event called SCAD (Spontaneous Coronary Artery Dissection), which mostly affects women under the age of 50.
What is SCAD?
“Unlike a normal heart attack, where blockage occurs due to plaque build-up, SCAD occurs due to a tear in one or more of the coronary arteries, reducing or blocking blood flow,” says Professor Robert Graham, Executive Director of the Victor Chang Cardiac Research Institute, which is conducting research into causes and best treatments for SCAD.
According to Graham, SCAD causes 25 percent of the heart attacks in women under 50 and two to four percent of heart attacks in women overall. After one SCAD event, there is a 20 percent chance that a woman might have another. “Though the cause of SCAD is not clear, our ongoing research suggests that genes may predispose some women,” Graham explains. “Activities like exercise and lifting weights or heavy objects may then become triggers because they put more pressure on the blood vessels. Childbirth also increases the shearing force through blood vessels so it can trigger a SCAD incident in women within days, weeks or months of giving birth.”
Unfortunately, diagnosis of a SCAD heart attack is often delayed because the women affected are not in a high-risk age group, may be sporty and don’t have classic heart risks like high cholesterol or elevated weight.
As a result, doctors may not order appropriate heart tests or may delay treatment. This puts women at risk of losing heart muscle during an undiagnosed SCAD event or having an undetected tear which may go on to cause life-threatening blockages or arrhythmias.
Living at risk
Pamela McKenzie, 46, from Western Australia, was doing laundry when she started experiencing a strange click in her chest, cold sweat and arm pain signaled her SCAD event. Her husband was away with work so she called an ambulance. “To later learn I’d had a heart attack and was lucky to be alive, was a huge shock because I was fit and healthy,” recalls the part-time sales assistant. “Then to be told the blockage was caused by SCAD was very distressing because I was terrified it might happen again. After finding little information about SCAD online, McKenzie set up a Facebook group which now has 200 SCAD followers.
“We often talk about living with the fear,” she explains. “When my heart rate gets up when I ride a bike or swim at the pool or even when I’m having sex, I often have a nagging worry it might trigger another heart attack.” As a result of SCAD, McKenzie now works part-time and is wary about traveling. “My husband really wants to go to Bali, but I’m too afraid of getting on a plane in case the pressure causes a SCAD event,” says the mother of four and grandmother of three.
McKenzie is on medications to reduce her risk. Treatment for SCAD often involves taking drugs to lower blood pressure and thin blood. Though the tear itself heals, usually within a year, stents or angioplasty (small balloons) may need to be surgically put in place to help keep arteries open.
“The first six months after my SCAD was a very draining and scary time in my life,” recalls Stearn. “I was exhausted 95 percent of the time, my body was adjusting to a cocktail of drugs, I was in pain from the broken ribs and unable to drive and walking was a real effort. It was also emotional and nerve-racking — each little twinge or pain I had in my chest I thought I could be having another heart attack. Going to bed each night I feared I might die in my sleep and leave my kids without a mom.”
SCAD completely changed how Stearn lives her life. “I used to be a stressed-out working mom. Now I make sure I don’t rush and I relax, rest and meditate. I do have a niggling worry about having another event but I try to put it out of mind and enjoy and make the most of every day.”