What one Colorado mom thought was a heart attack was actually an uncommon heart condition that impacts women much more often than men.
When Linda Tapia, an active mother of two, began experiencing chest pain, she knew something was wrong. But she also had no idea what could be causing it. “I am not the face of heart attack,” she said. “I’m healthy. I’m active. I hike. I ski. I love to be outdoors.”
It began on a Sunday morning. She was at home, emptying the dishwasher, when a sharp sting began to radiate from her chest into her jaw and down her left arm. She sat down and felt short of breath.
“When I got to the emergency room, the doctor came in and told me there was trauma to my heart,” Tapia recalled.
But the cardiology team at Kaiser Permanente, one of the largest multispecialty medical practices in Colorado, recognized that Tapia wasn’t having a heart attack. Instead, she was diagnosed with spontaneous coronary artery dissection (also known as SCAD). “It’s a tear in the artery or arterial wall,” explained DeeAnn Rivera, MD, a Kaiser Permanente cardiologist and Tapia’s doctor. “Blood then pools in the vessel, compressing the artery and stopping its flow to the heart.”
Many SCAD symptoms are similar to those of a heart attack: chest pain, shortness of breath, pain in the arm or jaw. It takes a keen eye—and some high-tech analysis—to diagnose it.
It’s unclear why, but SCAD impacts women at significantly higher rates than men and usually occurs between the ages of 30 and 50. Unlike a heart attack, risk factors such as high cholesterol, smoking, and diabetes aren’t linked to SCAD. During and after pregnancy can be riskier periods, but it can also “happen out of the blue,” Dr. Rivera said. The diagnosis accounts for around one-third of suspected heart attacks in women younger than 50. “SCAD is not common, but it’s also not super rare,” she added.
Tapia was lucky: She recovered quickly and didn’t require additional tests. But if she had, “she would have been in good hands with Kaiser Permanente’s integrated care model,” Dr. Rivera said. In this model, doctors, specialists, and pharmacists coordinate every aspect of patient care through a shared electronic health record system.
“I could have ordered those tests in the same office building and had the results come back to me the same day,” Dr. Rivera said. “With one click of a button, I have access to anybody else I need … [such as] an interventionalist, someone who is even more of an expert in the coronary arteries, to take a look if I have concerns.” At Kaiser Permanente, “everyone comes together as a team,” Rivera added.
SCAD has a high survival rate. It typically resolves itself with time, Dr. Rivera said, as was the case with Tapia, who was prescribed blood thinners and aspirin and was able to return home after just a couple of days.
Today, Tapia is back to enjoying the Colorado activities she’s always loved, like hiking and skiing. Dr. Rivera credited Tapia’s smart decision-making — going to the ER and seeing a doctor right away — for her positive outcome. “Sometimes, if a cardiac patient waits too long, the damage is done,” she said. “If you have something that is not feeling correct, that is not feeling right, get it checked out.”
Although SCAD isn’t linked to lifestyle choices, “it doesn’t mean you shouldn’t work to maintain a healthy heart,” Dr. Rivera said. She recommends a general regimen of a healthy diet and, of course, the type of active lifestyle that is central so many Coloradans’ lives. The Centers for Disease Control and Prevention also recommends quitting smoking, limiting alcohol intake, and generally keeping your stress levels under control (easier said than done, we know) to help reduce your chances of developing heart disease.
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