Why this healthy woman had two heart attacks at 41

Why this seemingly healthy woman had two heart attacks within a week of each other

Why this seemingly healthy woman had two heart attacks within a week of each other

Why this healthy woman had two heart attacks at 41

Why this seemingly healthy woman had two heart attacks within a week of each other

When you’re young and healthy, heart attacks aren’t really on your radar. But Jennifer Halvas, a 41-year-old living in Colorado, had two heart attacks within a week of each other— and she never saw them coming. Halvas told NBC 9 News that she was on vacation with her family when she suddenly developed intense pain in her chest, arm pain and shortness of breath. She went to her local emergency room but was told she was fine. The next day, however, she experienced more intense chest pain, and this time it radiated to both of her arms and neck. She also felt nauseous, had pain in her jaw and was vomiting. She was reluctant to return to the ER but she knew something was wrong so she trusted her gut and went back.Halvas was diagnosed with spontaneous coronary artery dissection (SCAD), a rare condition that happens when a tear develops in one of the arteries that provides blood flow to your heart, according to the American Heart Association. The condition can cause a heart attack, which is exactly what happened to Halvas.She was given medication to help with her symptoms and discharged from the hospital but, a week later, she experienced severe chest pain again and was told she'd had another heart attack due to her arteries contracting and closing. It’s been five years since her heart attacks, but Halvas is still on medication to control her symptoms and, if she misses a dose, she can get them again quickly. How common is it to have two heart attacks so close together?“It’s very unusual, but when one situation is not appropriately attended to, then sometimes it can spiral, escalate, and then you have two episodes back to back,” says Dr. Nicole Weinberg, a cardiologist at Providence Saint John’s Health Center in Santa Monica, California.SCAD is tough to treat and can make it more likely that someone will have a heart attack again, says Dr. Jennifer Haythe, co-director of the Women’s Center for Cardiovascular Health at Columbia University Irving Medical Center and cardiologist at NewYork-Presbyterian/Columbia. What is SCAD, and how is it treated?“SCAD involves a split in the wall of the artery and often we don’t like to put stents in arteries that have SCAD because you can split the wall more,” she explains. “Sometimes treatment is just to leave a patient alone, but you can have further dissection of the same vessel later leading to another heart attack.”SCAD in particular seems to have a “significant hormonal component associated with it,” Weinberg says, meaning it seems to disproportionally affect women who have regular periods or are pregnant or postpartum. It also seems to commonly affect women in their 40s and 50s, Haythe says. SCAD can be tough to diagnose because these women are often healthy. “Then, it’s not on a physician’s radar to think that this patient could be having a coronary artery problem,” Weinberg says. “As a result, this is very under-diagnosed.” What are the symptoms of SCAD?In general, they’re very similar to symptoms of other coronary artery problems — they just come on suddenly, Haythe says. Symptoms include chest pain, shortness of breath, back pain, nausea and vomiting. “They’re often worsened with some amount of exertion, but sometimes they just happen suddenly,” Weinberg says. If you’re having weird symptoms and you suspect it’s heart-related, but you feel that your doctor isn’t taking your symptoms and concerns seriously, Weinberg recommends insisting on certain tests. “A standard cardiac workup is very reasonable,” she says. “That means an EKG, blood work that looks for cardiac marker elevations and an ultrasound of your heart. Sometimes medical practitioners aren’t thinking it could be your heart and just don’t do these tests.” Remember, heart attack symptoms are slightly different in women than men.And, if you ask for the tests and your doctor is hesitant, Haythe recommends “making some noise” and pressing for answers. “Across the board, women aren’t being treated as much as they should and are being told they simply have anxiety,” she says. “You have to stick to your guns if you’re concerned and say, ‘I want you to show me why you think I’m okay.’”Bottom line: Weinberg says SCAD should be something that women in their 40s and 50s are aware of. And, if you’re having symptoms that just don’t seem right to you, speak up. “You are your biggest advocate for your health,” she says.

Halvas told that she was on vacation with her family when she suddenly developed intense pain in her chest, arm pain and shortness of breath. She went to her local emergency room but was told she was fine. The next day, however, she experienced more intense chest pain, and this time it radiated to both of her arms and neck. She also felt nauseous, had pain in her jaw and was vomiting. She was reluctant to return to the ER but she knew something was wrong so she trusted her gut and went back.

Halvas was diagnosed with spontaneous coronary artery dissection (SCAD), a rare condition that happens when a tear develops in one of the arteries that provides blood flow to your heart, according to the . The condition can cause a , which is exactly what happened to Halvas.

She was given medication to help with her symptoms and discharged from the hospital but, a week later, she experienced severe chest pain again and was told she'd had another heart attack due to her arteries contracting and closing.

It’s been five years since her heart attacks, but Halvas is still on medication to control her symptoms and, if she misses a dose, she can get them again quickly.

How common is it to have two heart attacks so close together?

“It’s very unusual, but when one situation is not appropriately attended to, then sometimes it can spiral, escalate, and then you have two episodes back to back,” says , a cardiologist at Providence Saint John’s Health Center in Santa Monica, California.

SCAD is tough to treat and can make it more likely that someone will have a heart attack again, says , co-director of the Women’s Center for Cardiovascular Health at Columbia University Irving Medical Center and cardiologist at NewYork-Presbyterian/Columbia.

What is SCAD, and how is it treated?

“SCAD involves a split in the wall of the artery and often we don’t like to put stents in arteries that have SCAD because you can split the wall more,” she explains. “Sometimes treatment is just to leave a patient alone, but you can have further dissection of the same vessel later leading to another heart attack.”

SCAD in particular seems to have a “significant hormonal component associated with it,” Weinberg says, meaning it seems to disproportionally affect women who have regular periods or are pregnant or postpartum. It also seems to commonly affect women in their 40s and 50s, Haythe says.

SCAD can be tough to diagnose because these women are often healthy. “Then, it’s not on a physician’s radar to think that this patient could be having a coronary artery problem,” Weinberg says. “As a result, this is very under-diagnosed.”

What are the symptoms of SCAD?

In general, they’re very similar to symptoms of other coronary artery problems — they just come on suddenly, Haythe says. Symptoms include chest pain, shortness of breath, back pain, nausea and vomiting. “They’re often worsened with some amount of exertion, but sometimes they just happen suddenly,” Weinberg says.

If you’re having weird symptoms and you suspect it’s heart-related, but you feel that your doctor isn’t taking your symptoms and concerns seriously, Weinberg recommends insisting on certain tests. “A standard cardiac workup is very reasonable,” she says. “That means an EKG, blood work that looks for cardiac marker elevations and an ultrasound of your heart. Sometimes medical practitioners aren’t thinking it could be your heart and just don’t do these tests.”

Remember, than men.

And, if you ask for the tests and your doctor is hesitant, Haythe recommends “making some noise” and pressing for answers. “Across the board, women aren’t being treated as much as they should and are being told they simply have anxiety,” she says. “You have to stick to your guns if you’re concerned and say, ‘I want you to show me why you think I’m okay.’”

Bottom line: Weinberg says SCAD should be something that women in their 40s and 50s are aware of. And, if you’re having symptoms that just don’t seem right to you, speak up. “You are your biggest advocate for your health,” she says.

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