Unique type of heart attack striking young women, UAlberta researchers show

“Tear-induced” heart attack becoming more common. Know the signs.


An unusual heart condition that is sometimes fatal has been identified in seemingly healthy younger women, new research reveals.

Kevin Bainey, a University of Alberta interventional cardiologist, is co-author of a study that looked at this specific type of heart attack with colleagues from Aston University in Birmingham, U.K.

“It’s an unusual type of heart attack because it occurs more commonly in younger females with no risk factors for heart disease. Roughly 70 per cent are women,” said Bainey.

Know the signs of SCAD

SCAD symptoms are similar to symptoms of a normal heart attack:

  • chest pain or discomfort including pressure
  • squeezing or fullness in the centre of your chest that last for a few minutes or goes away and comes back
  • pain or discomfort in one or both arms, the back, neck, jaw or stomach
  • shortness of breath

The condition, spontaneous coronary artery dissection (SCAD), occurs when one or more inner layers of a coronary artery tear away from the outer layer. Blood is able to flow into the space between the layers and a blood clot forms, reducing the flow of blood through the artery, leading, in some cases, to a potentially fatal heart attack.

Currently, the researchers estimate SCAD accounts for approximately 1,000 heart attacks in the U.K. (350 in Canada) each year, based on a unique supply of big data (33,000 patients over 14 years) and the ACALM data algorithm provided by study co-author Rahul Potluri, an interventional cardiology fellow at the U of A and research cardiologist at Aston University.

However, the researchers expect that number to increase with growing awareness among clinicians and better diagnostic tools.

“Our study has shed light on the characteristics of SCAD,” explained Bainey. “We now know SCAD patients tend to be younger than other heart attack victims, with an average age of 52, though it can happen in men and women who are much younger.”

On the other hand, he added, SCAD patients display lower rates of known risk factors such as diabetes, high cholesterol levels or high blood pressure, making them harder to identify.

Since studies have linked SCAD attacks to severe emotional stress caused by events such as sudden death in the family, extreme physical exercise and labour during pregnancy, it’s a good idea for all young people to watch for symptoms, especially at times of heightened emotional or physical stress, said Potluri.

“Emotional and hormonal factors play a big part in SCAD attacks, although the exact cause will vary from person to person.”

“A unique feature of our study found SCAD victims are less likely to need surgery (or angioplasty) and are less likely to die from the condition long-term compared to other heart attack sufferers,” added Bainey.

The next phase of research will entail establishing better diagnostic tools for clinicians. In the meantime, researchers suggest avoiding extreme emotional and exercise stress when possible.

The results were recently presented at the 2017 American College of Cardiology Meeting in Washington, D.C.