Even today the society is in the presumption that heart attacks strike only those above the age of 60 and that women are not victims to it most of the times. If this has been your ideology too until now please wake up! We are living in 2019 where diabetes is more common among children, there are an equal number of obese kids and adults in the society and where even youngsters die owing to unexplained causes of death more commonly than before! This is an era of diseases, infections and ailments that’s attacking many of us owing to our very own sedentary lifestyle practices and unhealthy eating routines! Heart disease is one such chronic disease that affects a majority of the population owing to rise in obesity/overweight rates and inactivity. But sometimes, a heart attack is not just a heart attack but is the result of spontaneous tearing in the coronary artery wall that happens due to SCAD-spontaneous coronary artery dissection. You might think that SCAD is just an addition alongside atherosclerosis (plaque buildup in arteries that restricts blood flow) that causes blockage of blood vessels leading to a heart attack but in SCAD, the victims are usually women especially otherwise healthy women in their 40s or 50s.
The artery wall has three layers and when a tear occurs the blood passes through the layers and gets trapped in the innermost layer bulging inward. This causes a block or narrowing of the artery resulting in a heart attack as the blood does not successfully reach the heart muscles. Most of the times it is atherosclerosis that’s the reason behind a heart attack and when a young patient does not exhibit any symptoms of it but does show symptoms of heart attack it might be SCAD. Although according to a 2018 statement by the American Heart Association (AHA) SCAD is the reason behind just 1-4% of all incidents of acute coronary syndrome its impact in women is highly disproportionate and AHA has concluded that SCAD might be responsible for up to 35% of heart attacks in women aged 50 or below.
Science Behind SCAD
Experts aren’t yet sure how SCAD happens but there are some studies that show a hormonal link where post-partum women (30% SCAD cases have this background) and those nearing or experiencing menstruation are at a greater risk. Estrogen and progesterone hormones can weaken blood vessels increasing the risk of tears as the one seen in SCAD. There are also theories that SCAD might be the number one reason for heart attack in pregnancy and post-partum period as this is the time when women experience fluctuating hormone levels. Some studies show that many of the SCAD patients have fibromuscular dysplasia where there is an abnormal cell growth in the arteries that causes bleeding, narrowing or tearing in the artery walls (aneurysm).
It is commonly observed that SCAD patients suffer from mental conditions such as depression, chronic stress and anxiety at a higher rate compared to other heart attack patients. It is also likelier that sudden stress that’s intense (such as when you hear the sudden demise of a loved one) can cause increase in blood pressure and heart rate that can end up in arterial tear. Coincidentally, women suffer more from depression and mental health conditions compared to men owing to numerous conditions such as the pressure to put the family’s priorities above their personal needs, lack of power in the society, absence of economic stability and victims of gender discrepancies and gender-based violence. In men, it is mostly physical exertion that triggers SCAD in them that includes anything like lifting something extremely heavy or running extremely hard in the race.
The distressing part about SCAD is that it is very difficult to diagnose before it causes damage to the heart as it silently does its job without showing any warning signs. Hence, this makes it even more necessary for the common man to be able to diagnose the symptoms of a heart attack that include chest tightness, shortness of breath, profuse sweating and dizziness. Other upsetting factors include the fact that its women who comprise of 90% of the SCAD population, SCAD doesn’t have risk factors such as high blood pressure or diabetes that’s typical of other cardiovascular diseases, occurs in those who have not reached the normal heart attack age which is 70 and might strike people who have not even reached the age of 55 where typical risks start arising.
Treatment for SCAD depends on the triggers and there are higher chances of recurrence which makes it necessary that these patients reduce the risk of heart disease as much as possible by leading a clean and healthy lifestyle. Learn how to prevent the risk of a heart attack with the help of the tips available at www.firsteatright.com. Being young doesn’t give you the privilege of a healthy heart. If you are a young woman who suffers from chest pain it is mandatory that you meet your physician and discuss about it.
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Dietitian & Nutritionist Dr. Nafeesa Imteyaz.