I’m okay, I promise, but last Monday I had a heart attack.
PSA to all my women friends – it didn’t feel all dramatic and serious like on tv, my chest just hurt, and my arm was a bit sore, so I popped in to the nearby medical centre on my way to work just in case. They didn’t think it was serious either, until about an hour later when the pain was getting more not less, so they did an ecg – and realised I was having a heart attack, and called an ambulance. The paramedics told me I should have called them immediately, but I just wasn’t sure it was something terrible – although I guess deep down I did…)
Heart attacks are more common than most of us think.Today in Australia 161 of us will suffer one.
💔 Cardiovascular disease (CVD) was the root cause of death in 42,300 Australians in 2019.
🔍 Spontaneous Coronary Artery Dissection (SCAD) is the leading cause of heart attack in women under 50 and cause of heart attacks in healthy, fit women and men of all ages.
👀 A SCAD is not caused by high cholesterol, high blood pressure or obesity.
Serene Conneeley had a SCAD attack this year. This is her story.
I’d never heard of a SCAD heart attack – until I had one.
As a fit and healthy vegetarian who exercises every day and doesn’t drink or smoke, I wasn’t too concerned when my chest was a bit sore one Monday morning as I got ready for work.
When my left arm started tingling, I decided to pop in to the medical centre on the way to the office just in case, but I still didn’t really think there was a serious issue.
Initially the GP didn’t either, he just thought I was having a panic attack, but after I did some breathing exercises and the pain increased rather than decreasing, he finally did an ECG (electrocardiogram) – and quickly called an ambulance.
When the paramedics arrived it all became a blur.
I was hooked up to their whiz bang new ECG machine and soon had a cannula in my arm and pain meds under my tongue – and was told that I was having a heart attack.
It was so surreal. How was I having a heart attack?
There was an ache and a pressure in my chest, and the pain had increased by this stage, but it wasn’t the dramatic sharp and stabbing, clutch-your-chest-and-fall-to-the-floor kind of pain you see in the movies.
According to the paramedic, it rarely is like that, especially for women.
A heart attack can happen to any of us
This is one of the problems with SCAD heart attacks. They affect fit and healthy women in their thirties, forties and fifties, although some are even younger, and the symptoms are mild and easily explained away. Some just think they went a bit harder than usual at the gym – while others only have back or shoulder pain as a warning before they go into cardiac arrest and need CPR just to make it to the emergency room.
Others have their symptoms dismissed because they look healthy and don’t have any risk factors or genetic predisposition for a heart attack, and some have been laughed at by medical staff and sent home, with sometimes fatal consequences.
Then it got worse…
Things sped up once the paramedics got me downstairs to the ambulance. At the hospital I was wheeled in for an angiogram, where they make an incision in your wrist or groin and thread a long thin tube into an artery and carefully guide it through the blood vessels to the heart.
They expected to use a balloon to insert a stent in my heart – but fortunately the doctor realised it was a SCAD heart attack, not a “traditional” one, and withdrew without doing anything. The cardiologist I saw a few weeks later said that in such cases a stent can actually cause more damage to the heart, rather than helping. Instead I’m on a cocktail of beta blockers and blood thinners, with restrictions on what I can and can’t do.
When reality hit…
I was in hospital for five days. For the first 24 hours I had blood pressure and heart rate monitoring every 15 minutes, but this eased as the medications started working.
I had more ECGs, as well as an echocardiogram, which shows the damage to your heart caused by the heart attack.
My most sobering moment came late one night when I googled SCAD. [Note to self: do not google health issues in the middle of the night!]
I’d managed to minimise my fear because everyone reassured me that it wasn’t a “traditional” heart attack – but unfortunately it does the same damage to the heart, and I suddenly realised how lucky I was that I checked it out – a SCAD heart attack can cause heart damage, acute coronary syndrome and even sudden cardiac death.
A few days after it happened I was supposed to fly to Brisbane for a conference, and it still sends chills up my spine to contemplate how differently it could have turned out if it had happened then.
Next steps…
Three weeks after my SCAD I saw my cardiologist, who is an incredible doctor who specialises in SCAD and gender inequities in health care.
Three weeks after that I had more tests done and saw her again. Unfortunately the damage to my heart hasn’t healed yet, but she assured me that that doesn’t mean it won’t.
I have to stay on all the medications, and have more tests in two months, then go back to the cardiologist again. Some women have had the all-clear one or two years after their SCAD, with the damage to their heart fully healed, and can go off some or all of their medications. Others have irreparable damage to their heart, as well as lower heart function, and will be on meds for the rest of their life.
My fingers are certainly crossed for the former!
It’s scary, but I try to get on with things
I also have to be tested for fibromuscular dysplasia (FMD), a rare blood vessel disorder that often accompanies SCAD.
I won’t lie, all of this does scare me, and I’m still trying to get my head around it all. But I know I’m in good hands, so I just have to be patient, and take it easy, and do what the doctors and rehab nurses tell me.
When it happened, I had to cancel a bunch of things and take time off from work, but it’s funny how priorities can change in an instant.
Here’s what has helped me
Two things have helped me come to terms with what happened, and to face the adjustment to my new reality.
1. Cardiac rehab
I’m doing cardiac rehab twice a week for five or more weeks at the rehab gym at my local hospital.
The first hour is physical – thirty minutes on the bike (up from fifteen on the first day), then building up to thirty minutes of a weights circuit. The first week I was only allowed to use 1kg weights, which was incredibly frustrating, but I’m slowly building back up, and hopefully I’ll be able to get back to my usual weights sessions eventually – although I won’t be able to lift heavy weights again, I can only do high rep, low weight workouts, which makes me sad. (But also, I’m alive, so…)
For one SCAD survivor, she was back at the gym within six months. For another, it’s been eighteen months and she still can’t walk more than the length of her driveway.
The second hour is a zoom presentation – to help me cope with the fallout of my SCAD. One was a psychologist talking about the emotional impact of facing a serious physical event. Others have been about physiotherapy, pharmacy (you can’t take turmeric, grapefruit, maca, licorice or ibuprofen while on my meds) or eating for a healthy heart – the latter not as useful for SCAD patients as most of us already do everything that is advised, and don’t do the things they want us to stop.
This coming week I also begin a stress management program for SCAD patients, as stress is a major contributing factor. And yes, it did follow a particularly stressful period at my day job.
2. Facebook
The other wonderful thing was finding a Facebook group of women who have all had a SCAD heart attack. (Yep, never thought I’d be thanking Facebook!)
It was reassuring to chat to people who understood how I felt, and had been through the same things, especially in those first days of trying to get my head around it all. They’re so generous in sharing their experiences, giving support, comforting and allaying fears. They’re also fierce advocates for our own health, and it’s awful that some survivors have had terrible experiences with doctors who had no idea about SCAD, and refused to listen to them, treat them properly, or do tests that other cardiologists insist on.
My new life – post SCAD
Five weeks after my SCAD, I did a 5km fundraiser for medical research, and met some of the women from the group, including Sarah Ford, who realised when she had her SCAD eight years ago that very little was known about it. She founded SCAD Research Inc Australia, and has been instrumental in raising money, gaining grants and driving research into causes, treatment and outcomes for this uncommon condition.
I am so grateful that I live in Australia and we have such an incredible health care system.
I’m also thankful that I live in the city, not far from an amazing hospital, because some SCAD survivors in regional areas have trouble accessing services or finding cardiologists who know about this specific type of heart attack.
And I’m beyond grateful to all of the medical staff who treated me, from the wonderful paramedics and doctors to the dedicated, compassionate and hard working nurses who truly are angels on earth.
What are the signs of a heart attack?
According to the Heart Foundation you need to watch out for these warning signs:
1. Pain, pressure or heaviness in your chest.
2. This discomfort can also occur in your neck, jaw, arms, back and shoulders.
3. You can also feel dizzy, nauseous, a cold sweat and short of breath.
Originally posted here.
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