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'I was in denial': When a healthy, young woman has a heart attack

'I was in denial': When a healthy, young woman has a heart attack

First came the exercise session. Next came the piercing chest pain. 

Dr. Aashrayata Pandit, a 39-year-old WellSpan neurologist, had embarked on a new workout regimen, doing high-intensity interval sessions with a trainer. After one such session, she arrived for work at her York practice but soon found herself experiencing chest pain that felt like "electric shocks." 

"It started getting worse and worse and worse, to the point where I couldn't stand up," she recalled. "I was almost disoriented at the time." 

It turned out that Dr. Pandit, a fit, young woman with no underlying health conditions, was having a heart attack, caused by a condition called spontaneous coronary artery dissection (SCAD). SCAD causes about a third of heart attacks in women younger than 50, many of them active women like Dr. Pandit, who have no family history of heart disease, according to the American Heart Association. It also is the most common cause of heart attacks in pregnancy. 

An ambulance took Dr. Pandit to WellSpan York Hospital, where she was given nitroglycerin tablets for the pain, an EKG, and a series of blood tests to detect if she had a heart attack. Dr. Pandit asked to be discharged when the first blood test came back normal. 

"I was in denial that this was heart-related," she said. "I thought it was maybe related to muscle pain because of my exercise." 

But two subsequent blood tests – which test for a protein that appears only when the heart muscle is damaged, as in a heart attack – showed elevated levels of that protein. That's when WellSpan cardiologist Dr. Jeremy Rier performed a cardiac catheterization to examine Dr. Pandit's heart and diagnosed her condition. 

While SCAD is uncommon, Rier and the WellSpan Heart & Vascular team have the expertise to both diagnose and treat a wide range of conditions. 

"Dr. Pandit matched the profile of many SCAD patients. She did not have heart disease risk factors and young healthy women with no risk factors simply don't expect they will have a heart attack," Dr. Rier said. "But imaging clearly showed what her problem was." 

SCAD doesn't cause a typical heart attack when blockages form in the artery and impede blood flow. Instead, SCAD is a separation of the three layers of the cardiac artery wall. When a tear occurs, blood can become trapped between the artery's layers and a bulge forms, blocking the blood flow and causing a heart attack. 

After treatment that included medication and six months of rest, Dr. Pandit returned to work in January. 

"I am feeling much better, and I am relieved I received a diagnosis and treatment for this unusual condition," said Dr. Pandit. 

Here are two takeaways for other women from Dr. Pandit's experience. 

Physical stress, such as the sudden, intense exercise regimen that Dr. Pandit embarked on, may have played a factor in her SCAD, Rier believes. 

"If you want to exercise, don't jump from one to 10," Dr. Pandit said. "Talk to your doctor, ease into it, and use a monitor to keep track of your heart rate." 

The other takeaway is to pay attention to chest pain and the other symptoms of SCAD she experienced, including pain in her back and left arm, sweating, and dizziness. 

"Take your pain seriously," Dr. Pandit said. "I am still very surprised to have had such a big cardiac event but do not ignore the signs. It could save your life." 

To learn more about WellSpan's cardiology services, go here.