By Karen Cicero, Prevention
You're 35. Fit. Normal blood pressure
and cholesterol. So there's no way that chest tightness you're feeling
could be a heart attack, right? Not necessarily. "The number one cause
of heart attacks in women under 50 has nothing to do with cholesterol levels,
weight, or fitness habits," says Alfred Casale, MD, chair of
cardiothoracic surgery at Geisinger Health System in Danville, PA. "In
fact, if you looked at a scan of the person's arteries the day before
their heart attack, you might say, 'They look great.'" (Looking to take
back control of your health? Prevention has smart answers—get a FREE book when you subscribe today.)
[post_ads]The sneaky culprit of heart trouble
in the 20- to 40-something age range is called SCAD—short for
Spontaneous Coronary Artery Dissection. It happens when the innermost of
the three layers of arteries supplying the heart with blood tears out
of the blue, causing a clot or flap that can narrow or even block blood
flow. Casale supplies 4 important facts every woman need to know about
SCAD:
No one is immune (but there are some things that increase your chances).
While SCAD can happen to anyone, 80% of
sufferers are women, and 30% of SCAD heart attacks occur in the third
trimester of pregnancy or soon after delivery. "We think hormonal
changes late in pregnancy that help loosen the tissues in the birth
canal for delivery also affect the blood vessels in the heart too in
some women," he says. (Here are 7 hormones every woman should understand.)
[post_ads_2]
People with connective tissue disorders, especially noncoronary
fibromuscular dysplasia, also have a greater chance of suffering from
this type of heart attack. In fact, one study
of 116 SCAD patients at the Mayo Clinic found that 44% of them had this
disorder. And being young doesn't protect you: The average age for a
SCAD heart attack is 42—that's well below 70, the average age for women's heart attacks overall.
The symptoms are identical to heart attacks in older people.
Signs of SCAD don't differ from a typical
heart attack, which is caused by a build-up of plaque. But, in general,
women of any age experience subtler heart attack symptoms than men, says Casale. "Think more like chest discomfort or tightness than crushing pain. The pain could also be in your jaw, shoulder, or arm," he says. If you have these symptoms, don't hesitate to go to the ER because time is of the essence. (These 10 symptoms also warrant a trip to the ER.)
"If we can get an artery open within 90 minutes, you have a much better
chance at getting back to full speed," he says. That's because heart
muscle can deal with not having enough blood for about an hour and
half—after that, it starts to die.
Prevention Premium: If You Think Lowering Your Cholesterol Is The Best Way To Prevent Heart Disease, You Need To Read This
The treatment may not be typical.
You'll get blood tests in the ER to determine if you're having a heart attack. "Whether the heart attack is caused by the usual plaque or SCAD, the tests will pick it up,"
assures Casale. From there, you'll likely be transported to the cardiac
catherization lab. That's where doctors will be able to tell what
caused your blockage.
[post_ads]If it's plaque, chances are you'll receive a
stent—a wire mesh tube that props open an artery. But if it's SCAD, a
stent may do more harm than good. "Stents are effective 90 to 95% of the
time for a heart attack caused by plaque, but only 60 to 70% of the
time for a SCAD heart attack because the tissue is more fragile," Casale
says. Your doctor will make the judgment call as to whether to go the
stent route or treat your blockage with blood thinners alone.
Putting things in perspective...
You can stop freaking out. Even though SCAD
is the top cause of heart attacks in women under 50, thankfully heart
attacks in this age group just aren't all that common overall. For
instance, the risk of a 35- to 44-year-old white woman having a heart
attack is 1 in 5,000, and it's about 1 in 1,000 for African American
women, according to the American Heart Association.
Still, "the thing I want women to remember is if something doesn't feel
right in your chest, get it checked out," says Casale. "Emergency-room
doctors would much rather send home a patient than miss a heart attack."
(Doctors want you to know these 6 unexpected heart attack triggers.)
