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Carmen Martinez Johnson knows that good days can quickly turn bad. It’s okay to be stuck in traffic for an hour on your way to work. You may also receive unexpected charges or uninvited visitors.
Carmen has had her bad days, but nothing derails her like the sudden change in trajectory she experienced on a recent sunny afternoon. She had one of her coronary arteries open. Just like that, she went from having a healthy image to having a heart attack.
“It was life or death,” Carmen said. “I thought I was going to die.”
Carmen managed to call 911 from her home, but then collapsed to the floor with severe chest and back pain, shaking, sweating and short of breath. She was extremely weak and had lost feeling in her left arm.
Dr. Ernest Umana, a cardiologist at Tallahassee Memorial Healthcare, diagnosed Carmen’s condition as spontaneous coronary artery dissection (also known as “SCAD”) after several diagnostic tests in the hospital’s emergency room. A tear develops within one layer of her coronary artery, causing blood to pool and restricting blood flow to the heart.
The arterial wall consists of three layers. When a tear occurs, blood can become trapped and bulge inward, narrowing the artery. Spontaneous coronary artery dissection is a much rarer type of heart attack than a heart attack caused by plaque buildup in and on artery walls (atherosclerosis).
Treatment for SCAD patients also tends to be different than for other heart attack patients. Conservative measures such as blood pressure control and prescription medications are more likely to be the approach than stenting or bypass surgery. Carmen is not scheduled for stent placement or bypass surgery.
Carmen, who is 43 years old and appears to be in good health, fits the SCAD profile. SCAD can develop at any age and can occur in men, but it most often affects women in their 40s and their 50s. And Carmen is typical of other patients with this condition in that she does not have risk factors for heart disease such as high blood pressure, high cholesterol, or diabetes.
She is physically active.
She doesn’t drink or smoke.
She eats healthy and maintains a healthy weight.
Carmen is not pregnant and hasn’t been pregnant recently. There is some correlation with SCAD, pregnancy, and women who have recently given birth. SCAD appears to be more likely to occur in women during the first few weeks after giving birth.
Researchers believe multiple factors play a role in SCAD, including genetics, arterial abnormalities, hormonal influences, inflammatory issues, and illicit drug use, but the most common trigger is extreme Many people think that it is physical or mental stress.
In Carmen’s case, stress is the main cause. A big part of your future treatment plan will be stress reduction. Although she loves her job and finds it rewarding, she also finds it very stressful.
She works with emotionally challenged children (Apalachicola Forest Youth Camp).
“I have to think of another job,” Carmen said jokingly. “My job could cost me my life.”
Mark Ryan is an RN in Tallahassee.
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