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Spontaneous Coronary Artery Dissection

WomenHeart
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**Originally posted by user katy 06/20/2005 : 22:29:37 **

Ten years ago, when I was 38, I had a heart attack. I was told it was a spontaneous coronary artery dissection(LAD). I had angioplasty and have had no problems since, but doctors don't know why it happened or if it will happen again. I had no history of heart disease or had any risk factors. I currently take a 81 mg. aspirin everyday. Is there anyone who has had this happen to them, or has any information on this subject?

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47 replies

WomenHeart

**Originally posted by user dirksie 07/07/2005 : 22:37:17 **

January 1996, I had two heart attacks resulting from two spontaneous coronary artery dissections, two weeks apart. I was otherwise healthy with no heart problems previously. I had no problems after that, but then in May 1997, I experienced chest pain, and after doing an angiogram, they discovered that I had been having dissections all during that year. That's when they started me on coumadin, norvasc, toprol, and isosorbide. I kept on having chest pain and was admitted to the hospital several times a year for several years. When they did the heart tests they found no heart-related problems. Now, after all this time, my primary care physician thinks that the wall of my esophagus may be constricting. Now, I'm seeing a gastroenterologist to find out if that is the problem. I sure hope so!

WomenHeart

**Originally posted by user Texheart 07/08/2005 : 10:06:06 **

Very interesting story, Dirksie. Can you let us know what your Gastroenterologist has to say. How was your dissection treated? Can a Esophageal problem cause this? Did they do a TEE Echo on you?

I wish you all the best.

WomenHeart

**Originally posted by user Judith Marie 07/16/2005 : 20:54:23 **

On July 2nd of 2005 I experienced a Dissection in my heart that resulted in a heart attack. This past January I had spent several days in awfull pain in my lower abdomin only to discover I had a Dissection in the main artery just where it splits for the groin area. I am hoping someone knows of a place where they are researching this type of medical problem. Please contact me if your experience is similar.

WomenHeart

**Originally posted by user maeblessed 07/16/2005 : 22:05:08 **

This is very interesting Dirksie - just curious about your breathing - I notice that you take isosorbide - so do I - keep us posted on the outcome.

WomenHeart

maryelle
**Originally posted by user maryelle 08/17/2005 : 23:04:55 **

I was diagnosed on Aug. 10, 2005, with a spontaneous dissection of a coronary. My cardiologists were stunned when they did the angiogram and found this, saying it only presented in 3 out of every 1000 procedures. I am 53 years old, and had no predisposing factors; in fact, my arteries had no plaque, my blood pressure runs low, no smoking,no drug use, occasional drinking, etc. My symptoms were very benign--a dull ache and pressure in the center of my sternum, which I first noticed immediately following a very stressful encounter with an angry co-worker. After an hour had passed and the pressure didn't subsibe, I left work and thankfully went to the ER. Has anyone else out there who is in good health had an experience this following an emotionally stressful encounter?

WomenHeart

**Originally posted by user Texheart 08/18/2005 : 08:37:11**

Mary, what did they do to correct this? I also have that dull ache in my sternum that I have had since I fell off the cardiac Threadmill. I have had a heart cath since then and no mention made. But, I keep complaining about it. Did you have other symtoms? Does this dissection cause a heart attack.

There is an article I read recently about women who have these so called attacks of "something" produced by Fright, Anger, Sadness. They called it something like Emotional Cardiomyopathy and it was written by a Dr. Witstein at John Hopkins Hospital. I am wondering if you had similar? How are you doing now?

WomenHeart

**Originally posted by user maryelle 08/18/2005 : 17:56:35 **

What the doctor did following the angiogram was put me on IMDUR 30 mg and Toprol XL 25 mg and a daily Aspirin 325 mg. I spent two days in the hospital so they could monitor reaction to the meds. The doctor also ordered me into cardiac rehab, which I just started today. I will be going to cardiac rehab 3 times a week for a few months, and I will have a echocardiogram in September to see if my heart is responding to the cardiac rehab and the medications and repairing itself. The good news is that in my case and if the therapy and drugs work I may make a full recovery and may not need to be on the medication on a longterm basis. I hope this helps you to better understand your symptoms. In my case, the doctor did not feel that a heart stint was necessary and that I would have a good shot at a total recovery without the stint. But the spontaneous dissection of my coronary was indeed a heart attack and a very, very rare occurrence. I'm feeling better, but I still can't believe how quickly this happened and of course, I'm concerned about what to expect going forward. I will check out the article you suggested, and thanks for passing it on!

Edited by - maryelle on 08/18/2005 18:18:02

WomenHeart

**Originally posted by user enharris 08/19/2005 : 10:50:20 **

Hi all! I'm new to the site and wanted to share my story on this topic. I was diagnosed with CAD in September of last year, I'm 31 years old and had no risk factors. I had heart palpitations for a while, but thought it was an elevated heart rate (which occurred while working out). Little did I know I was having angina everyday (minor heart attacks). I had several tests done and had angioplasty with 3 stents. Now I take 4 meds everyday to keep everything under control - they found over 90% blockage in 2 of my main arteries.

My entire life has changed for the better and I'm taking life 1 day at a time. I have attached a link to the American Heart Assn's website with my story for your reference and inspiration.

http://americanheart.org/presenter.jhtml?identifie r=3032957

It gets better...you learn to deal with it and manage each day with your HEART in mind.

WomenHeart

**Originally posted by user Texheart 08/19/2005 : 21:14:07 **

Thanks for sharing your story. Unfortunately there are hundreds of women exactly like you out there. Me included. I had to fight tooth and nail to be heard. I was laughed at and yelled at by a group of cardiologists. This time,I was not going to let up until I had the heart cath. I had a 99% blockage in the Mid LAD and 75% in the RCA and an area in the Distal LAD that was so bad...they were unable to stent this. WHY? Because precious time had flown by with no intervention due to lack of "believing a woman could possibly have heart disease"

Your very fortunate that you feel good. Many of us do not because intervention came too late. Good Luck To You and Good Luck to all HD Women of the world.

WomenHeart

**Originally posted by user janet 08/25/2005 : 19:10:54 **

2 weeks ago I had a heart attack while working alone. Thankfully my heart attack presented with the very typical band of pain and squeezing across the chest and I recognized that although I shouldn't be having a heart attack at 41 yrs old I might actually be having one. It took me a matter of 2 minutes or so to decide that I was leaving and going to the medical clinic which was about 7 minutes away. It was the best decision I've ever made. By the time I got into the clinic I was starting to crash. It was absolutely obvious what was happening and the doctor and 2 receptionists quickly started helping me and called the ambulance. When I was given oxygen I started to feel much better and stablized but if I'd stayed at my client's home I don't think I'd be here now.
I spent 2 night's at our regional hospital waiting for a bed in one of our major centers. Then I was med-evaced by plane to Vancouver where I had an angiogram which showed that I had a spontaneous dissection of my LAD coronary artery and the doctor did angioplasty and put in 3 stents. Fixed! No more chest pain!
Since then I've been gradually feeling better although I'm having problems with my blood pressure being low - 88 over 52. No wonder I'm dizzy! I'm anemic so my heart rate is high and the med I'm taking to slow my heart-rate lowers my already low blood pressure. Meds I take now are ASA, Clopidogrel (Plavix), Ramipril (Altace), Metoprolol and Iron.
My doctors, like everyone else's, don't know why this happened but are investigating into possible contributing factors (anemia, low blood pressure, a recent nasty intestinal illness starting 2 weeks before my heart attack, lasting one week and causing intestinal bleeding- caused by campylobacter jejuni bacteria). The weather was also hot and I don't handle heat well. In addition, I had chronic stress, sometimes extreme, for the last 2 years (my daughter is now recovering from a profound case of Anorexia Nervosa which threatened to take her life - but that's a whole different story!).
In addition to seeking information about the spontaneous dissection of coronary arteries I'm wondering what other people's possible contributing factors may have been. I'm also wondering how this has changed other women's lives.
Hope everyone else is doing fine!!!

WomenHeart

**Originally posted by Texheart 08/25/2005 : 21:26:25 **

Hi there. You mentioned that your bP is low. Hoe much Topol are you one? I was on 25mg and then 50mg and provided my BP was not too low, they added another 25mg. I am now on 75mg and my BP is still waxxing and waning between 117/68 to 144/78. My pulse never goes below 80 which concerns my doctor. Just exactly is a dissection of the coronary artery? I had similar experience in May...stress, lots of coffee, three puffs of albuterol inhaler, the night before and ended up with an Atrial Fib attack (186 BPM), weakness, sweating breathlessness and some left shoulder and arm pain. They thought I was in a thyroid storm or I was an alcholic. Nada to both. I just read on the Cath report the word dissection but it does not say whether this pertains to an artery. The doctor said I did not have a heart attack but a heart event. The MID LAD was stented. I read more women get this than men. I am really curious about this dissection and are we prone to having more? Good Luck to you..

WomenHeart

miracle
**Originally posted by user miracle 04/28/2006 : 22:30:30 **

hello my name is amber and i am from michigan nov 2004 i was 32 weeks pregnant and was in the hospital recovering from having emergency appendix and hermia surgery it was late evening and i had the onset of chest and arm pain and i thought that at the age of 29 there is no way this is what i think it is having no prior cardiac history for myself nor in either side of my parents the dr came to my room and an ekg was done and discovered that i was having an mi aka heart attack i was flown to borgess medical center where i underwent an angioplasty and had 5 stents placed 2 days later i was transfered to bronson methodist where i was kept till i delivered nov 22 ,2005 a very healthy and luck baby girl olivia we are both very very lucky to be alive i was paddled 5 times during my procedure so everything i went thru so did my baby up until this past feb 18 , 2006 i was great taking my meds a told i was at work and went into v-fib which is a rythem that will kill you also know as sudden cardiac death again was flown to bronson where i had an icd placed because of my heart attack i now have an arythmia thank god for techniology or i would not be here so for the age of 30 i feel great just been thru a lot would love to hear from anyone who had had the same experience god bless you all !!!

sunshine5406

I also had an appendectomy when I was pregnant and then my heart attack. I would love it talk more on this with you Miracle. Maybe there's something with the whole pregancy thing . . .

KAKLeon

Yes, there is something heart related with pregnancy, but most OBs don't even know about it.

Although I didn't have an appendectomy, I did have a postpartum dissection and heart attack in April of 2003 when I was 38. My second son was 2 months old, and the doctors kept saying "of course you're tired, you have two kids under 2 years." They blamed my severe chest pain on everything from asthma to my gallbladder. On the second trip to the ER, they admitted me and did an echo and cath. My dissection was at the top of the "fork" of the LCAD (doctors call it the "widow maker" -- nice) and caused two blockages. We went from the cath lab to the operating room for an emergency double bypass!

I have searched and searched to find others with this experience. My doctors were no help. They say since most women die on the spot or need a heart transplant, there are not many suvivors to study (great). Some of the theories they've offered up are that the stress of labor causes the tear, or a congenital defect was there all along.

At an appointment last year, my cardiologist assured me that the latest thinking is that it's estrogen related. (I was worried I could have passed the defect to my sons.) You know how your joints and everything loosens up with pregnancy? Well, he said a type of estrogen causes the loosening, and this is what doctors believe causes the arteries to weaken and dissect. He and the surgeon said they've seen this happen in the third trimester, during delivery, or months afterward, like me.

I was so glad to see these posts. When I joined WomenHeart two years ago, it was depressing to not find any information. I hope my comments are helpful -- and I hope I did this right. I've never done an online post before!

sunshine5406

I know one of the surgeons I had when they thought it was pregnancy hormone related said that there is 3 very different physiologies, male, female and the pregnancy female. And there is a HUGE amount of knowledge yet to be learned from the pregnant female. They really had no answers for me except that with so many unknowns it could have been caused by hormones.
And that mine too most often occurs in third trimester or weeks to a couple months afterwards. I think they say that with every heart related thing when I pregnancy is involved!
Since you had your bypass so young too, have they said anything to you about having surgery again for it ? Will the bypasses need to be redone after so long? Just wondering what I am really in for.
Thanks for your response!!!!
Take care
Chris

KAKLeon

Oh my gosh, I just erased my entire reply by going backwards in the browser!

Let me start over. First, I am so saddened to read your story. I thought mine was bad, but you have definitely been through the wringer. You have incredible strength. And I can completely relate to the "walking time bomb" feeling. I used to get so tired of people telling my how lucky I am, etc. when most of the time I wasn't sure whether I'd drop dead or not the next morning! Plus, I was missing so much. Sometimes I felt like a ghost watching life go on while I sat on the couch with my leg up, hugging my heart pillow.

Not to try to read your mind, but it helps me just to think that the reason I'm still here is to do my job, which is to raise my boys into solid citizens. Whether or not I'm glad about it from day to day is just part of the process. My husband is great about letting me have my pity parties! Lately, I'm definitely more glad than sad, but it has taken quite some time.

Regarding your question ... I've had different answers from the nurses, rehab folks and doctors. Basically though, the mammary artery in the chest wall is supposed to last "forever." I've heard that the ones from the legs and arms last 12-15 years. But the cardiologist acts optimistic about the different techniques and advances they may make in that period of time. Personally, I figure we're in for another graft or stent or something.

I saw your comments about scarring too. My situation hopefully won't be yours ... my sternum didn't grow back together so I had two additional surgeries to remove the wires and band together the fractures. So it took about two years to be pain free from the sternotomy. My lower scar is horrible. They removed the xiphoid process during the reconstruction surgery so the scar is WIDE. I quit wearing bras and just buy cheap camis with the shelf bra so the elastic is way low around my ribs. This Christmas, I finally said the heck with it and used makeup on the top of my scar so I could feel comfortable wearing a V-neck top.

One surgeon said use a silicone based cream to massage the scar. But I've also heard your genes play a big part of how it heals.

Lastly, I wondered if you doctor is watching your cholesterol. My guy made me start taking Lipitor this fall because my "bad" number crept up to 102, which is nothing! He said heart surgery patients should keep that number under 70, which sounds impossible without drugs.

Do you have a lot of support around? I remember feeling so depressed for the three months that I couldn't use my arms, etc. So hard with babies. Do you have boys or girls?

Katherine

sunshine5406

Wow, can you imagine if we all wrote a book about our experiences!
I'm glad to hear your doing well! My doctors have basically told me the same thing about additional surgeries, I'm a little bit of a freak though because my original arteries reopened and are perfectly normal. I guess the grafts now are functioning are a backup. So, when the grafts go bad, I'm not sure if they need to be redone if my normal arteries are still good.
That is so amazing about your sterum not growing back together! I didn't know that wasn't an option! Wow. Do you have to be extra careful or do the bands do the job?
I dont even think about the scar. I see it I guess but don't make a point of noticing it. Not sure how I got over that one! Ha Ha!
My bad cholestrol has been around 24. I take 20 mg of lipitor every night. I didn't have a cholestrol problem before this whole event, and they tell me I am taking it now as a preventative. I have read numerous times though that too low of cholestrol can be bad too. What can you do? I guess damned of you do and damned if you don't.
My support system has been amazing! From family, friends, people at my daughters school and people from my work, it has been very heart warming, humbling and embarrassing. I hate asking for help! But I was very grateful since just lifting my newborn was off limits. They would put him in my arms when I was in my rocker and I would hold him for hours! Could be why he's such a mommy's boy and spoiled!! LOL My husband has been my rock, guardian angel, you name it! I love the guy to death and know he would do anything for me. We firgure if we lived through all we have in the past 2 years, we can make it through anything. We have yet to have our first fight.
How old are your boys now?Aren't they absolutely amazing? I thank god everyday things worked out the way they did.
Thanks so much for responding! Hope this finds you happy and healthy!
Chris

AuntieMom

In September I went to the Women's Heart Health Center in Providence, Rhode Island. I was told by the specialist there that with women's hearts they are more concerned about keeping the HDL UP than keeping the LDL down. She told me that I should be walking at least a half hour everyday and taking 3 Tbsp. of olive oil every day. I do the olive oil in the morning by dipping bread into it - that way I know that I had gotten in my 3 Tbsp.

When I had labs done in August (a month before my appt. with the specialist) my HDL was down to 32. When I had labs done in November (after a month and a half of olive oil and exercise) my HDL was up to 59.

Just a little tid bit that I picked up along the way.

KAKLeon

I think my cardiologist's concern is in preserving the bypass grafts and that's why his focus is on the LDL. But thanks for the tip. I'll ask him about it at my appointment.

CJM3

I can't believe what I just read! My doctors told me the same thing. I should be happy that I was alive and that I did not need a transplant. I have found it very frustrating in not being able to find anyone who has survived with the same treatment that I had. I had a dissection in March of 2006. My youngest baby was 1 1/2 but I got my period the day my arteries dissected causing my heart attack. My mom said that I needed to find someone with a similar experience as I have been very frustrated since then.

My doctors seem to think that it is estrogen related as well. Every month when I got my menses after my bypass I would get severe chest spasms landing me in the ER for several days. After 5 months I ended up atthe cleveland clinic. They found that my main artery that had dissected had healed itself. However I was now having coronary artery spasms where my artery would collapse for no reason cutting my blood supply off completely. It would get exceptionaly worse around my period. After many trial and error drugs (including a stint with lupron ..a drug that made me go into menopause) I ended up being referred to a cardiologist in California. It was only then that I was finally put on the right meds not only to live a "normal" life but ones for prevention as well.

How are you doing now? It is so scary. I have 2 young daughters and I am scared something may happen to them. I also have a twin sister who is a little paranoid these days as well. It has been extremely hard learning to except my new life (only being 39 )and put behind me my life that was....

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