07 May 2019
Mum of two toddlers, Kate Alderton, was just 30 years old when she experienced spontaneous coronary artery dissection (SCAD) – a life-threatening yet little-understood heart condition that occurs without warning, predominantly in women under the age of 50.
SCAD is essentially a heart attack, caused by an artery wall tearing, which makes blood clot and restricts arterial blood flow, therefore leading to a possible heart attack or cardiac arrest. This differs from the more common type of heart attack, which may happen due to coronary heart disease or atherosclerosis – conditions that are both common in smokers or people with high cholesterol – which cause fatty deposits build up in artery walls and block the flow of blood to the heart.
Kate had no history of heart problems when she experienced SCAD. Being a dietician, she ate a balanced diet, was a healthy weight and, as a regular runner, she was very active – not considered to be at risk of ill health in the slightest. In fact, she took part in a 10km run the day before she had a heart attack.
“I ran a bit slower than expected and I had a bit of chest pain but I also had a cold so I thought that was the cause.”
Kate’s chest pain developed into further symptoms the next morning at breakfast.
“I had the typical symptoms of a heart attack – chest tightness, difficulty breathing, shooting pain down my left arm, jaw pain etc, but I never considered anything would be wrong with my heart at 30! When the first responder came they thought it was probably a panic attack. The paramedics did an ECG and told me it was abnormal – if I was older they would have suspected a heart attack. It wasn’t until I was in the cath lab having an angiogram that the cardiologist could tell what had happened.”
Kate was lucky in that her diagnosis was fairly swift, which isn’t always the case as SCAD is a rare condition that many medical staff have never dealt with before. Some women report that they have presented to their GP with SCAD symptoms but been misdiagnosed as having anxiety, indigestion or other minor illnesses.
Kate had to have heart surgery to repair the artery, specifically an angioplasty, to open up her damaged artery with a small balloon. Four days later, she underwent an angiogram, a type of x-ray that helps check if blood is flowing correctly, which enabled doctors to check the artery wall had healed. After a short six-day stay in hospital, Kate was sent home to recover, which proved to be a physically and emotionally challenging time for her and her family, especially with two young children to care for.
“Immediately after and for a few weeks, I could barely walk. I was so tired and, due to all the medication for my heart, I kept fainting because my blood pressure was so low. I had friends come to stay to ‘babysit’ me when my husband went back to work. It took a while for what had happened to sink in. Initially it was hard because I lost all faith in my body and felt it could happen again at any moment.”
Kate’s treatment was ongoing and six months after the SCAD she had a longer hospital stay where she underwent a positive electrophysiology study to look at her heart rhythms. It was during this study that Kate found she had lasting damage to her heart after the SCAD, leading to the insertion of a subcutaneous implantable cardioverter defibrillator (ICD) under the skin of her chest. An ICD monitors heart rate and can deliver electrical shocks and impulses to restore a normal rhythm when required. After her SCAD, Kate found her life changed forever in more ways than one.
“I still take some medication everyday which does make me tired as it slows my heart rate down, but that has improved greatly since I cut my hours at work and started running again. It has meant we cannot safely have any more children which has had the biggest emotional impact. This was the hardest part of the whole experience. I know I have lasting heart damage but I can do my best to minimise the effect that has on my life. There is nothing I can do to compromise on not having any more children. It is often assumed that because I already have two children that this is not a great sacrifice, which is hard to deal with. It did, however, mean that I finally won the argument with my husband and got a puppy (he couldn’t really say no!)”
As SCAD is considered a rare condition, it is not well understood, but there are some theories about what causes SCAD in otherwise healthy people, 80% of whom are female. Research is taking place with funding from British Heart Foundation by Glenfield Hospital and the University of Leicester, under the direction of Dr David Adlam, which Kate is involved in as a trial participant. She is also supported by a patient-led charity called beatSCAD.
“SCAD is not well understood at all. There is a fantastic patient group led by SCAD survivors who work tirelessly to raise awareness and, because of them, the British Heart Foundation funded research into SCAD. Glenfield hospital and the University of Leicester are leading the research. When I had my SCAD I was googling from my hospital bed and got in touch with Dr Adlam, and volunteered for the patient research. They suspect hormones play a large role – many women who experience SCAD have recently had a baby and I had very suddenly stopped breastfeeding. They think exercise may also play a role. Watch this space! There is a great Facebook group and many ways SCAD survivors can share their stories and experiences.”
Everyone experiences SCAD differently, and Kate’s story of survival is a positive one. She now looks at life with gratitude and takes pleasure in living in the now.
“Someone told me once ‘you won’t feel the same as you did before but try getting used to your new normal’, and that’s what I have done. I also feel very lucky. When I was in hospital straight after it had happened I asked one of the doctors if I would live to see my eldest daughter go to school and he said ‘we don’t know anything at the moment’ so to feel as well as I do, to be working, spending lots of time with my family and to have just completed a half marathon I definitely feel very lucky! It has made me grateful for normal days and all the little things.”
Kate’s advice to others who experience SCAD is:
“Don’t push it - sleep when you’re tired. Don’t waste time worrying about what might happen. Exercise. Get a dog!”
We would like to thank Kate for sharing her story with us. Find out more about SCAD at the beatSCAD website.
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