SCAD and the Sticky Little Monster That May Be the Culprit
By Nefertari Williams
It has been almost 18 years since my coronary artery spontaneously ruptured while I was nine months pregnant. The words look so calm as I type them, one letter appearing after another in an organized, rhythmic pattern. However, the event was anything but calm. It was the most terrifying experience that I have ever had. And worst of all, no one could tell me why I had a heart attack as a young, fit, 34-year-old former model.
My artery tore. How does that happen? I didn’t even know that could happen. But yes, that’s how it was explained to me, and nothing in my life has been the same since. Over the years, I have seen, been examined by and spoken to some of the top cardiologists in the world. All have played a part in getting closer to solving the mystery: Why did this 5-foot-9 mother of four (and one on the way) have a spontaneous coronary artery dissection (SCAD) heart attack? One specialist who follows SCAD survivors noticed that a lot of us had something in common. We were all active people who pushed our bodies to extreme limits. Another explanation came after a conversation with my specialist. I told him about my mother’s debilitating stroke, and he concluded that immense stress may have caused this life-altering event.
I learned that I have a condition that affects my connective tissue called Ehlers-Danlos syndrome. This diagnosis could partly explain my ruptured artery — but not entirely. It’s still rare to have a coronary artery rupture. What piece of the puzzle is missing? I may have found it. My search may be over. Recent studies have made people more aware of a particular cholesterol, different than we normally hear about. This cholesterol is called lipoprotein(a), or Lp(a), a mostly genetically determined type of cholesterol particle. (There are also some conditions that can increase your Lp(a) level, such as diabetes and chronic kidney disease). In layman’s terms, Lp(a) is a sticky cholesterol that causes issues in your body. It’s passed down in your family and not caused by something that you can control, such as diet and physical activity. It has been found to affect African Americans at a higher rate, and I am African American. A blood test showed that my Lp(a) level is extremely high; all my other numbers were normal.
This sticky little monster lurking in my arteries, combined with my other diagnosis, may have been the culprit. Having high Lp(a) can cause plaque buildup and narrowed arteries. It can also increase inflammation and blood clotting. In my case, a rush of blood tore an artery apart, creating a crushing heart attack while I was pregnant. That baby is 17 now. We made it. Lp(a) is something we need to watch closely. We need to ask our doctors how this affects us because it’s not yet included with routine blood tests. Hopefully, that will change soon.
Many of us have had heart attacks or strokes all while trying to do everything to prevent that from happening. I am one of you. I did my very best to battle heart disease, the No.1 killer in the U.S., yet I still had a heart attack. Now that Lp(a) has made its way into mainstream media, and more research is being done, maybe we will soon have answers and be on our way to treating this sticky little monster that is causing so many problems within our arteries.
The Lp(a) Discovery Project is supported by Novartis Pharmaceuticals Corporation.
For more information on this topic, visit www.heart.org.
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