Heart attacks: The six surprising risk factors for a tear in your blood-supplying artery

What's the difference between a heart attack and cardiac arrest?

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A heart attack occurs when one or more of the coronary arteries—blood vessels that have the all-important task of delivering oxygen to the heart—become blocked, according to the National Institute of Ageing. This causes the part of the heart that doesn’t have enough oxygen to start to die. There is another potentially fatal heart condition seen more in younger women.

Spontaneous coronary artery dissection (SCAD) is a tear in an artery supplying blood to the heart.

It is a common cause of serious or fatal heart attacks that occur in women under age 50.

SCAD can slow or block blood flow to the heart, causing a heart attack, heart rhythm problems (arrhythmias) or sudden death.

People who have SCAD often don’t have risk factors for heart disease, such as high blood pressure, high cholesterol or diabetes.

SCAD can cause sudden death if it isn’t diagnosed and treated promptly.

A major cause of heart attacks in women is SCAD.

Although the cause of SCAD is unknown, there are a number of risk factors.

These include:

• Female sex
• Recent childbirth
• Irregular growth of cells in artery walls (fibromuscular dysplasia)
• History of migraine headaches, depression/anxiety
• Use of hormones in oral contraceptives or infertility treatments.

Experts know SCAD is rare, but they are not sure exactly how often it happens.

It has historically been underdiagnosed, mainly because heart attacks aren’t often suspected in younger, healthy women. Providers may also be less familiar with it as a cause of heart attack.

In the general population, SCAD is estimated to cause just one to four percent of all incidents of acute coronary syndrome (a range of conditions that suddenly prevent blood flow to the heart), according to a 2018 scientific statement on SCAD from the American Heart Association (AHA).

A 2019 research paper published in the Canadian SCAD study found that women are estimated to comprise over 90 percent of SCAD patients.

Many women with SCAD don’t have most of the risk factors you see in other cardiovascular diseases. What’s more, SCAD affects many people who haven’t yet reached the average heart attack age, which is over 70 for women.

These patients often haven’t even yet reached the age at which heart attack risk typically starts to rise, which is 55 in women.

According to the Mayo Clinic, symptoms of SCAD may include:

• Chest pain
• A rapid heartbeat or fluttery feeling in the chest
• Pain in the arms, shoulders or jaw
• Shortness of breath
• Sweating
• Unusual, extreme tiredness
• Nausea
• Dizziness.

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