Spontaneous Coronary Artery Dissection

Chest pain denial

March 22, 2021

I am a 55 y/o female with a past medical history of gastrointestinal reflux. I am active, work full time, exercise regularly and I have played beach volleyball since high school. Because of my reflux I have believed all of my life that I have esophageal spasms. I have had episodes of severe chest pain since college. Very infrequently but definitely the same pain that made me go to the hospital on 12/8/2020.

I had been having this same chest pain intermittently for 2 weeks. I was in the process of a stressful divorce and just found out that my husband had a girlfriend and confronted him with it. I had thought it was weird that I was having chest pain so frequently over those two weeks. It never was that frequent. I had it driving into work several times on the expressway and actually thought that if it got any worse I would pull over and call 911. The pain was severe and sharp and radiated to my neck , jaw, teeth, ears and down my arms. Then I started to have sweating and nausea with it. I would walk into work and question whether I should detour to the emergency department but felt foolish thinking “I am a healthy woman with no risk factors” and thought I would be laughed at.

After a very bad incident I finally promised myself that if it happened again I would go to the emergency room. The pain woke me up from sleep at 330 am and I had my son drive me to the ED. I am a physician assistant who works in medicine at a busy city hospital. I have lectured my patients and family and friends about the importance of talking to the doctor about serious things like chest pain. I have yelled at family members for driving themselves to the hospital and not calling 911 for things like chest pain. Here I was ignoring the symptoms, diagnosing myself and having my son drive me to the hospital. I thought I would be embarrassed to go and find it was just reflux.

In the ED the doctor told me my troponins were elevated and I had a heart attack. I was so shocked. The cardiologist then came and told me I was very “interesting” because I had no risk factors. They did many tests and found on cath that I had SCAD. I remember telling the cardiologist when they told me that “I am a vegetarian!”. I am embarrassed to say that I waited so long to get checked out and went against all of the advice I have ever given to others.

Denial is a powerful thing. I am still trying to go about my life and it is scary now knowing there is a chance it will happen again. I am part of the SCAD registry so I can hopefully do something to help others. I tell my colleagues and friends about my experience. I had never heard of SCAD in all my years in hospital medicine. I am trying to spread the knowledge.