Dissecting a rare heart condition

Ana Gregg never imagined she'd have two heart attacks by age 35. Why she now has hope and wants to help others understand their risks.


At 35, Ana Gregg never imagined she'd have a heart attack at such a young age. Or that her doctors would initially miss the signs. Now Gregg is participating in a research study at Mayo Clinic in Rochester that she hopes will help researchers better understand the mysterious medical condition called spontaneous coronary artery dissection or SCAD, which caused her to have two heart attacks.

It all started one night shortly after she had put her two young sons to bed. After the boys fell asleep, she decided to take advantage of some "me time" by exercising. When she finished 45 minutes later, she says she began feeling warm, and then felt pressure building in her chest. "At first, I thought I had worked out too soon after dinner," she told the Twin Cities Heart Foundation in a video created for the Go Red campaign to help raise awareness of heart disease in women.

"I thought maybe it would just go away," she says. But instead, things got worse. "I was having a hard time breathing … I looked in the mirror, and I was gray." At that point, Gregg says she knew something was seriously wrong and went to a local hospital. An EKG initially showed she was having a heart attack. "I was shocked," she says. Almost as a shocked as she was a few minutes later when another doctor came in and told her he didn't believe she was having a heart attack. Instead, Gregg says that while her initial EKG results were "abnormal," the doctor told her "that could be my normal." So she was sent home and told she had acid reflux.

Nine months later, however, it happened again. And Gregg told Mayo Clinic News Network that it was after this second go-around that her doctors realized what was going on: She had suffered SCAD. "I couldn't believe it," she says. Fortunately, Gregg has since become part of the aforementioned research study led by Mayo's Sharonne Hayes, M.D., who's doing all she can to solve the SCAD puzzle.

Dr. Hayes says what makes SCAD so hard to understand is that it's not your typical heart attack. "Instead of plaque building up, the artery splits," she says. And when it does, that initial tear allows blood flow to split the artery wall, creating a "loose flap of tissue" on the inside of the artery that can then restrict blood flow to the heart. While there's still much to be learned, research by Dr. Hayes and her team has helped shed some light on the condition. That includes indications that angiograms could make the problem worse by lengthening the tear, that patients with SCAD are at a higher than expected rate of having an artery condition called fibromuscular dysplasia, and that recurrence is not as rare as once thought.

Ana Gregg is thankful her condition was caught when it was and is hoping the seven stents she now has placed in her chest will help reduce further risk by keeping her arteries open. "Every day I think God has given me a new day," she says.

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