Susie Carlson has always been active and healthy, but her heart attack last year is one of few cases in the medical mystery known as SCAD.
Susie Carlson does nothing by halves.
The Northside fifth-grade teacher is always active: whether it’s teaching kids, taking walks, doing workout videos, working out - she’s full of life.
Prior to March 10th, 2017, Susie Carlson never had a major health problem.
Prior to March 10th, 2017, Susie Carlson never had any debilitating heart issues.
But on Friday, March 10th 2017, Susie Carlson suffered a heart attack.
That day was a regular day of constant activity for Carlson: she finished up teaching, she exercised with a co-worker, attended a chiropractic appointment, worked at her son Logan’s choir concert before spending time the night at home.
“I had began experiencing fatigue and drowsiness that week but I chalked that up to my normally busy schedule,” said Carlson.
Susie began experiencing an abnormal wave of hot and sweaty to cold and clammy sensations in rapid succession. As she was attempting to adjust to the dysmorphic drops in her temperature, her chest began tightening.
“At first it felt like someone as squeezing my heart,” said Carlson. “But then it felt like someone was standing on it.”
The cool and collected Carlson wasn’t alarmed until she began feeling pressure from her elbow to her hand -- rendering it numb.
“It felt like my heartbeat was here [elbow to hand area.]”
Normally one to fight through pain, Susie alerted her daughter Maddie and her best friend to take her to the St. James Mayo Clinic, two blocks from the Carlson household.
Initially, doctors declared that Carlson was suffering from a standard heart attack. But then further testing revealed a much more curious case.
After checking her troponin levels, proteins that are released when the heart muscle has been damaged during a heart attack, they found them to be absurdly high.
What was even odder was Carlson’s condition - she remained fully conscious and wasn’t feeling any residual pain from her attack.
“It’s weird because I felt so much better, no more pain and then they brought me to Mankato Mayo Clinic for further testing.”
At Mankato’s cath lab on March 11th, doctors found that Susie had arteries in her heart that were dissecting and tearing paths of blood circulation to her heart.
That’s when doctors realized Susie’s heart attack was not just a heart attack. It was the result of spontaneous tearing in the coronary artery wall.
It was a SCAD.
What is a SCAD?
Spontaneous coronary artery dissection (SCAD) is a rare occurrence. According to the American Heart Association, “SCAD is difficult to diagnose before it causes a heart attack because it doesn’t have any warning signs. And although it can cause a life-threatening heart attack, SCAD patients don’t typically have other heart disease risk factors.”
Carlson, however, is an ultra-rare case for SCAD because she doesn’t fit the profile of most SCAD victims.
Most SCAD sufferers are new mothers or recently pregnant women.
“I was an exception, and doctors couldn’t chalk up precisely why I got it,” said Susie.
Susie’s treatment for SCAD was much different than a normal heart attack treatment.
Treatment for SCAD patients differ from other heart attack patients who may require a procedure to insert a stent to hold the artery open or bypass surgery.
If doctors implemented a stent, Susie’s arteries would have a good chance of bursting.
For SCAD patients, more conservative therapy that emphasizes blood pressure control and medication.
Which is why Carlson’s treatment consisted of an exact dosage of 81 grams of aspirin. Soon in five days, Carlson arteries began a self-regeneration.
But for doctors, SCAD is still a mystery.
While most heart attack can be linked to abnormalities in blood pressure or cholesterol, SCAD is traced to non-quantifiable factors such as potential stress levels or anxiety levels.
In Susie’s case, her SCAD didn’t have a definitive cause or trigger.
“I’m outside the normal range of SCAD victims and I don’t experience a ton of stress.”
Approaching a year since her SCAD, Carlson feels great; if not better.
“I feel pretty good, I feel better when I did before that,” said Carlson. “But I’m much more cautious of what I eat and do.”
A year removed from her incident, Carlson has done her part to help bring awareness about SCAD.
She is one of the subjects of a study done by the Rochester Mayo Clinic to determine more accurate information on SCAD. She also is apart of a Facebook support group of SCAF survivors.
“It’s such an empowering group because since SCAD is so rare it’s good to know there’s a community of people who experienced what you went through.”
Some women may experience SCAD again even after it has been successfully treated; this can happen shortly after the initial episode or even years later.
As of February 2017, there are no advanced medical journals or studies on SCAD.