A New Normal

Healed from her unexpected heart attack, Kim Cowperthwaite still struggles to explain the inexplicable

It’s 3 a.m. and I am somewhere between sleep and wakefulness. My mind starts tossing this theory around about what caused my heart attack: It must have been something in the tap water…bacteria…some sort of unfilterable pollutant…something that has molecules that bind to migrating endometrial cells and causes them to adhere to the arteries of women and BINGO! A bulge and a tear in the arterial wall, blockage, heart attack.

It’s been almost four years since my heart attack, and still my mind tries to make sense of the inexplicable label: spontaneous coronary artery dissection. It cobbles together bits of information I have collected from reading medical research, talking with my doctors and maybe from reading sci-fi. Most of my theories would be nonsensical to scientists, but it’s the best I can do as a writer and English teacher. Besides, even the world’s top cardiologists and researchers have been unable to figure out what exactly causes a healthy woman’s heart to tear apart.

Spontaneous coronary artery dissection, or SCAD, is an uncommon cause of heart attack or cardiac arrest not related to coronary artery disease, and it happens primarily to women with no risk factors. With SCAD, a tear spontaneously occurs in the lining of a coronary artery and, sadly, can be fatal, especially if symptoms of chest pain are not taken seriously by first-responders and clinicians. I am very lucky that, on the night of May 7, 2014, there was a team in the emergency department of Maine Medical Center that swiftly and correctly diagnosed my SCAD.

My story is much the same as the other women I have met and chatted with online who have survived a SCAD. We start our stories with “out of the blue” and “I thought it was nothing.” My symptoms began when I tasted chili that I was stirring on the stovetop. The spiciness made me cough hard and I swallowed a gulp of ginger ale as I was coughing. A feeling as if I had to burp welled up in my chest and around my back. My throat began to burn, I presumed from the spicy fresh peppers I had just tossed into the pot. I patted my chest a bit and walked around the house with the strange sensation, wondering why I could not get the burp up. I sat down on my bed for a while, but began to feel panicky and a tingling sensation started in my left arm. I’ll never forget my son saying, “Mom, those are symptoms of a heart attack.” My husband noticed that I looked gray and grabbed the car keys. Racing me to the hospital, despite my protests of “But I just have to burp!” was the first step that saved my life.

To be told I was having a heart attack by the team in the emergency department of the hospital felt surreal. I was 47 years old, had low cholesterol, exercised, was a healthy weight and ate a mostly vegetarian diet. At the catheterization lab, an extensive spiral dissection in my left anterior descending artery was identified and I was off for open heart surgery and an emergency coronary artery bypass graft.

I am grateful that I do not remember much past this point except my surgeon Reed Quin smiling at me afterward when I was still quite groggy and saying matter-of-factly, “Well, we fixed you!”

They did. They fixed me. I healed.

“I walked, I rested, I meditated. I prayed and visualized my heart beating healthy and my bypass graft functioning smoothly.”

On one level, that’s the end of my story. My body healed rapidly. I took the summer to complete cardiac rehab. I walked, I rested, I meditated. I prayed and visualized my heart beating healthy and my bypass graft functioning smoothly. I connected with supportive people and doctors and educated myself on everything related to SCAD. I have even moved past a tremendous amount of residual fear that I believe all heart attack survivors must face. With the exception of the large “zipper” scar that runs down my chest, you would not know I had heart surgery.

But on another level, my story continues. There are pieces of the plot that are my “new normals.” I will always be monitored by a cardiologist—one in Maine and a SCAD specialist in Boston. I stay tuned in to the rhythms and sensations in my heart, especially when I exercise. And because SCAD remains idiopathic, cause unknown, I continue to read the research and scholarly articles that are related to women’s heart health. The 3 a.m. theories continue to pop into my mind.

Most of all, I am now compelled to educate every health professional I meet about SCAD. While emergency protocols to take all cardiac symptoms seriously in all people are becoming more common and awareness of SCAD is increasing, there is still a long way to go to get the message out: healthy women can have heart attacks.

Recently I met an emergency department nurse who works on the West Coast. I asked,  “Do you know what spontaneous coronary artery dissection is?”

“Yeah, it means you’re dead,” she replied.

“Well, I’m not.” And I told my story again.

Kim Cowperthwaite is a writer, an English teacher, and a survivor of a heart attack caused by Spontaneous Coronary Artery Dissection. She is 51 and lives in Windham. She is writer of the blog Every Open Heart.

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