1. Diary of a SCAD Heart Attack Survivor - Day Zero
Published - 31/07/2021
Spontaneous Coronary Artery Dissection (SCAD)
A heart condition that cannot currently be predicted or prevented.
Yet.
Day 0 - March 2021
"I am so sorry. I was wrong. You have definitely had a heart attack. Probably two. Your enzyme levels show, quite categorically, that there has been damage and death to the heart tissue, which is what happens when someone has a heart attack."
In my little, blue-curtained cubicle in the Accident & Emergency area, I stare at the senior doctor, a lop-sided smile somehow appearing on my face.
It’s like as if my face doesn’t quite know what shape to make with its’ muscles.
I am sitting on the hard, grey, plastic chair, facing the back of my little cubicle, trying to avoid people.
It is 2021, Covid times. Me and 1000’s of others have been absolutely killing themselves at their places of work to comply with Government guidelines to reduce the risk of infection and now, I’m right in the thick of strangers who couldn’t care less. Including some of the staff whose masks are hardly on and, unlike the private clinics that I work in, nobody here is cleaning and sanitising the loo after every Tom, Dick & Harry have used it.
Awesome.
Plus, a guy had entered the Accident & Emergency area some time ago, and sat down to wait for treatment NOT WEARING A MASK. Kerrrist!… he is breathing directly towards me. Granted he is about 4m away, but still, I can do without this! The first time the senior doctor had seen me, she had laughed, “you really don’t want to be in here do you?!”
“Eh no. Howsabout you just ask that dude to stick a mask on love?”
Thankfully, I just thought it.
And, another reason that I wasn’t much up for sitting up on the hospital bed, was because my new middle name was,
'Denial'
"I’m not sitting on a hospital bed!
Me?! Mrs. Relatively Fit!
I was practising handstand press-ups a week ago..."
Why Go To A&E?
Symptoms
Sudden onset of uncomfortable chest pressure sometime around 12-1pm
Same pain as happened 2 days ago.
Sudden vice like pain in centre of chest - resulting in me going onto the floor on my hands and knees to try to relieve the pain. Pain level 8-9/10. Lasted 15 minutes approx.
More extreme than happened 2 days ago but very similar.Pain sort of reduced to about 5-6/10 so my partner - Cameron - and I tried to ‘walk it off’.
For the record, one can’t ‘walk off’ heart attack pain.Pain reduced a little but utter, utter exhaustion took over.
Called local GP. No-one would speak to me unless it was covid or mental health related.
As it was Covid times, there was no way I was ‘popping’ in to A&E.
You’ld have to drag me over hot coals to go there. Or I’d have to be unconscious.
I have a ‘thing’ about people going to A&E for trivial ailments like a sore throat and, again, IT WAS COVID times, they’re busy!! A&E = accident and emergency NOT All and Everything.Cameron has private healthcare through his work. He got me a video appt with a GP.
1st available was at 22:30 that night.I did my dad’s shopping, drove on the bypass and went back to my place.
An inexplicable feeling of ‘impending doom’ began.
Pain began to radiate at the top of my left shoulder up to my jaw.
The inexpilcable feeling of something very, very bad happening became worse. I called Cameron to come to mine.
(He wasn’t best pleased…. neither of us thought that anything ‘bad’ was happening)I explained my symptoms to the online GP who said, “why are you not at A&E?!”
I’ll paraphrase, she told me to go straight there, if Cameron could drive me all the better, would save waiting for an ambulance.
In a bit of a daze we went, but now…. I’m feeling guilty and a fraud for being there.
I’ve been triaged.
The female nurses were not interested, nor worried. Nor anything really.
My ECG tracings, oxygen levels and blood pressure are all "fine".
I receive a number of eye-rolls from 2 of the nurses, one just after I’ve told them that I have pain in my left shoulder and jaw.
I have repeated my symptom-story to about 4 different people, over the course of the last 2 1/2 hours.
I’m walking, talking and not bleeding profusely from anywhere... OK, my breathing is laboured and my chest hurts like hell but still, you know.... surely I don't require the services of A&E?......
But, I do have a really, really sore chest…like an elephant is sitting on it.
And he's been there for the last 11 hours.
Seems like said elephant is quite comfy on my wee chest.
Initial Diagnosis from Senior (mid-life female) Doctor
“As it happened around lunchtime, on both occasions, it must have been something you ate. You must have gastritis. We’ll have your blood tests back shortly but you can go home now.”
Even though I tell her that I’d know if I had an upset tummy, due to my digestive issues a number of years ago, this is ignored and hell who cares?!
I’m being ‘let out’!
I mean… I still have the chest pain and my breathing is still difficult, but I’ve had enough of this nonsense and want to get out to my man who has been waiting in the car for nearly 3 hours now in -1C degrees temperature.
(Due to the Covid pandemic, only patients are allowed in to the hospital)
The senior doctor has gone so I call Cameron to let him know my ‘diagnosis’ and that I’ll be out very soon.
“She says that you have Gastritis?!
Babe, I don't even really know what Gastritis is, but I'm pretty sure that whatever is wrong with you, has got absolutely f*** all to do with anything you've eaten today”.
He is royally p****d off.
"I mean.. sheesh".His exasperation is obvious, "you had a few oatcakes and humous today - like you ALWAYS have for breakfast. I mean... NO, no, I'm ragin', are you SURE I can't come in?"
He is very royally p****d off.
And baltic-ly cold.
I sense that the mind of my lovely, normally super-calm, logically thinking man, who always takes everything in his stride, is feeling somewhat fried and is slowly exploding.
Second Diagnosis from the same Doctor
It was at that moment that the Senior Doctor came back with the bombshell news,
“I’m so sorry. I was wrong. You have definitely had a heart attack. Possibly two. Your enzyme levels show, quite categorically, that there has been damage and death to the heart tissue, which is what happens when someone has a heart attack.”
I ask her permission to keep the call with Cameron open, so that he can hear what is being discussed.
Use Your Phone!
During any discussions about your symptoms or treatment, have somebody on the phone 'with you',
a '3-way' conversation.
You won't feel alone.
. The medics will feel more comfortable in the knowledge that, whatever they are saying is being understood by someone other than a potentially, rather poorly patient.
(Well, some of them will, others…..)
With the benefit of hindsight, I am in denial at the news - to be honest, I remain in denial for the next day or so.
Part of me is relieved (& grateful) that the senior doctor has reviewed and apologised for her initial diagnosis of gastritis - thank heavens for Troponin blood tests eh?!
Part of me... well... as I say... DENIAL is my current default position.
The next 30mins are a blur.
To Cameron, "yes, she has had a heart attack."
Me, “so I’m not going home tonight?”
To me, "No! You are not getting out tonight! You’ve had 1 or 2 heart attacks, you will be transferred to the Acute Medical Unit.
Fuck.
"You are, the quietest heart attack patient I have seen in my medical career."
I most definitely have to be back up on the bed now.
After nearly 12 hours of severe chest pain and nearly 3 hours in A&E my little cubicle becomes ever so busy.
About half a dozen medics are buzzing about, and all seem to be talking to me at the same time;
I wonder if these medics will go back to the triage team and let them know my diagnosis. Especially the female triage nurse who could barely control her eye-rolling and look of annoyance when I repeated that I did have pain in my left jaw and shoulder…..
Then they're gone.
And now I'm scared.
I’m on my own.
My man has left the freezing cold car park and gone home.
And the machine that I'm now attached to, is beeping away, whilst the blood pressure cuff periodically inflates and deflates, all serving as literal rhythmical reminders that actually, I'm really not very well.
I've had more drugs injected, poured and pumped in to me tonight, than in my entire life, and I have no idea what they're for or, what they're doing for me.
Then I find out.
My heart starts going like the clappers!
My arms and legs are... I would say 'tingling' but that sounds quite pleasant, it feels like every nerve in my body is exploding.
Is this normal? Is this what is meant to happen? Nobody has told me anything. Nobody is around.
And I can hardly get up off the bed and go find somebody whilst attached to all these machines.
And then, finally, the pain in my chest stops.
I can breathe fully again.
Oh halleluyah!
The pain that's been there for the last 13 hours has, at last, gone.
So that's what the drugs are for then!
Cool!
So I'm better yes?
I can go home in a whiley, yes? (I could be awarded a Bafta in Denial)
It's only 10 minutes away from the hospital and my man is there.
The irony is that, for the first time in my life, I do have a partner who will actually be there for me. But he can't.
Unfortunately, I ain't going home - the nurse looks aghast when I ask her!
"Oh no Jill, you've had a heart attack, you're going up to the Acute Medical Unit, and a cardiologist will see you tomorrow” (It's 1.30am right now)
Oh.
Ok.
Right then.
I know I don't normally like Mondays but this Monday.... it had defo turned out to be a bit of a random day.
But that's OK.
Tomorrow I'll go home to my 6'4" protector, feel his (inordinately) long arms around me and all will go back to normal.
Won't it?
Coronary Heart Disease (CHD) kills more than twice as many women as Breast Cancer in the UK every year,
and is the single biggest killer of women worldwide.
Despite this, it’s often considered a man’s disease.
The British Heart Foundation, Women & Heart Attacks.
SCAD = Spontaneous Coronary Artery Dissection
when a tear or bruise develops in a coronary artery that prevents normal blood flow. This can cause -
heart attack, heart failure, cardiac arrest, can be fatal.
Current data indicates:
90% of patients are female with an average age of 44-53,
– many of whom have no or few heart disease risk factors.
ECGs and O2 levels may be normal.
Assess troponin levels, repeating 4 hours later.
(NB. Trop levels may be clinically insignificant)
For information:
https://beatscad.org.uk/what-is-scad/
https://academic.oup.com/eurheartj/article/39/36/3353/4885368