SCAD: The Heart Attack That Strikes Healthy Young Women

Teri Hontz of Whitehall had just hit the dance floor at a wedding in 2015 when she was overcome by excruciating jaw pain. She quickly sat down, but continued feeling lightheaded and clammy. Her husband wanted to call 911, but she insisted it would pass.

"I knew these were heart attack symptoms, but I didn't believe I was a candidate for it," Hontz says.

"I was only 47 and super healthy. I exercised regularly and didn't have high cholesterol, high blood pressure or diabetes."

Painful symptoms persist

During the following weeks, Hontz continued experiencing jaw pain, burning in her chest and breathlessness with minimal exertion. Her primary care doctor finally convinced her to visit the ER at Lehigh Valley Hospital (LVH)-Muhlenberg. Fellowship-trained cardiologist Nidhi Mehta, MD, with Lehigh Valley Heart and Vascular Institute and the Women's Heart Program, immediately ordered tests.

"We thought she might have coronary artery disease caused by plaque buildup in her heart arteries that was blocking blood flow," Mehta says. "But a cardiac catheterization didn't show any blockage."

After more tests, Mehta concluded Hontz had suffered a heart attack caused by a condition called spontaneous coronary artery dissection (SCAD).

"SCAD is unlike coronary artery disease in which arteries narrow and harden due to cholesterol buildup. Instead, for reasons not entirely understood, the coronary artery tears, which causes blood to pool and slows or blocks blood flow," Mehta says.

This can cause heart attack, heart rhythm abnormalities or sudden death.

SCAD expertise is crucial

SCAD mainly affects women in their 40s and 50s who don't typically have heart disease risk factors. It causes up to 35 percent of heart attacks in women under 50 and is the leading cause of heart attacks during pregnancy.

"Treatment is different than for traditional heart attacks, so early identification is key," says fellowship-trained cardiologist Ellina Feiner, MD, with LVPG Cardiology.

"Our Women's Heart Program has the largest team of female cardiologists in the region who are skilled at treating SCAD."

Living fully

Despite some damage to her heart, Hontz's artery tear is healed, and she's back to her fitness routine. She credits Mehta's quick action and treatment plan, which includes taking a daily baby aspirin and low-dose cholesterol medication.

"I continue to work out, but I don't overdo it," she says. "Fortunately, Dr. Mehta is always there whenever I need advice. I'm lucky to be alive."