SCAD takes pregnant mum by surprise
Heart troubles were the last thing young and healthy Kerrie expected, but at 12 weeks pregnant with her second child, she experienced a spontaneous coronary artery dissection (SCAD).
In September 2016, the day of Kerrie’s SCAD began much like any other when she took her two-year-old son, Jacob, for a walk.
“I found myself really tired, really quickly,” recalls Kerrie. “I had to stop often and catch my breath, which I put down to being pregnant. When I made it back to the car, it took me a few minutes to slow my heart rate down and relax enough to drive home.”
Kerrie found it strange that she felt so tired after such a short walk but went home and carried on the day as usual. By the afternoon, she was still tired so rested in bed, while her partner, Daniel, gave Jacob a bath.
Experiencing a SCAD
“I could hear Jacob crying in the bath, so I got up to see what was going on. I lifted myself off the bed and as I got up I felt this intense burning right throughout my chest and back, and up the left side of my neck. Both of my arms felt numb, but achy and tingly. I was in a lot of pain.
“I remember pacing round the house and I wasn’t in my right frame of mind. I couldn’t take in what anyone was saying. I started to get hot and sweaty and I felt sick, so I ended up in the bathroom. I had really bad morning sickness anyway, and it didn’t take much to set it off.”
The pain settled slightly after Kerrie vomited, but 40 minutes later she could still feel the ache in her chest and neck. Daniel had gone out to buy some food, so Kerrie called her mother-in-law to stay with Jacob while she went to hospital.
“I got to the hospital and gave them my symptoms and they told me to sit and wait. It wasn’t that long that I had to wait but it felt like forever. I was so scared and alone, I had no idea what was going on, but I had a feeling that something was really wrong.”
Searching for a diagnosis
It never crossed Kerrie’s mind that the pain could have been caused by a heart problem. She was more concerned that it was something to do with her pregnancy.
The Emergency Department (ED) doctors suggested a few things that could be going on, but the results of a blood test showed that Kerrie’s troponin levels had raised dramatically, and an ECG showed significant changes in her heart’s activity.
Kerrie was monitored over the next few hours. Then, much to Kerrie’s surprise, a doctor told her she could go home if she was feeling better. Even though the pain had gone, Kerrie wasn’t comfortable leaving, so she stayed overnight and the next day was referred to cardiology.
In the morning, Kerrie’s cardiologist explained they suspected she’d had a SCAD.
“I remember sitting there thinking ‘what the hell? Are you serious? I’m 23! This isn’t supposed to happen.’ I burst into tears. I had no idea if this was a life-long thing or what it meant for me and my baby. I was terrified for the baby, more so than for myself.
“My mother-in-law told me “you’re going to be ok” and was trying to be positive about the situation, but at that point I saw it as a death sentence. I had no idea what the prognosis was.”
As Kerrie was pregnant, doing an angiogram to look at her arteries was too high risk, so she was given an echocardiogram (PDF) to assess the damage to her heart. She was then moved from Waitakere Hospital to Lakeview Cardiology at the North Shore Hospital to be monitored.
Once at Lakeview, Kerrie’s cardiologist came to visit with the results of her echo and confirmed that she had indeed experienced a SCAD. He recommended Kerrie stay in hospital for a few days to see if she had any more symptoms.
“He explained that a lining in my artery had torn and folded in on itself, which had created the blockage. So it was a heart attack, but not in the way of clogged arteries or plaque, it was more a mechanical issue.”
Concern for her baby
Kerrie was extremely concerned about her baby and asked if someone could come to check that everything was fine.
“The midwife said, “we’re only at 12 weeks, so don’t freak out if we don’t hear anything”. But we heard the heartbeat. That was a huge emotional moment for me. Just to know my baby was there and was ok.”
For the next four days, Kerrie was monitored in hospital. She was encouraged to get up and move around but was worried that when she got up the SCAD would happen all over again. Kerrie remembers the time in the hospital as very lonely and that visits from her friends and family were what kept her going.
Kerrie was determined to get back to her family, so when she was booked in for a stress test (PDF), that was her “ticket out of there”.
The test went “pretty much perfectly” and Kerrie was allowed home, much to the delight of her son, five days after the SCAD.
“The look of excitement on Jacob’s face when I said to him that I was coming home with him today still makes me feel emotional. He was just ecstatic. I sat in the back of the car with him and he kept looking over at me in amazement, like ‘Mum, you’re here!’”
Kerrie’s cardiologist told her to rest, not to do anything strenuous and gave her aspirin and beta blockers to steady her heart rate.
“I remember feeling happy I was home but still very unsure. I just didn’t want to go to sleep at all, in case I didn’t wake up. The plan at that point was not to do anything invasive throughout my pregnancy. And to wait until after the birth to investigate more.”
Pregnancy after a heart event
Kerrie was referred to the high-risk maternity ward at Auckland Hospital, and had monthly scans to check on the progress of her baby, all of which were completely normal. She also had a check-up with her cardiologist, who wanted to see how she was doing and see that she’d had no further symptoms.
It was recommended Kerrie have an elective caesarean to minimise the stress caused by labour on her heart, and baby Leah was born a happy and healthy little girl at 39 weeks.
After Kerrie gave birth, she was referred for an angiogram, however, after a long wait, the hospital called to say they didn’t want to go ahead with the test as so much time had passed it wasn’t guaranteed that they would see anything. Instead, she was booked for a CT angiography.
However, on the day of the CT angiography, Kerrie’s heart rate was too high for the test and it had to be abandoned.
Kerrie made a follow-up appointment with her cardiologist and was told that the results of her recent ECGs and echo test looked fine. She was told she no longer needed to be under the care of the cardiology department and that if she wanted to have another baby, it would be classed as a normal pregnancy.
“I walked out of there feeling good that he wasn’t concerned about anything at all. I asked him “what are my limitations?” And he said “nothing”.”
After that appointment, Kerrie joined the SCAD support group on Facebook.
“It was amazing to see so many people were living normal, everyday lives. After time, things will get better. I’ve learned sometimes it is normal to be really tired. That it’s not just in my head.”
Looking back, Kerrie remembers how scared she was of having another SCAD after she gave birth. When Leah was a few months old, Kerrie was feeling depressed and anxious so was referred onto the maternal mental health team.
“You don’t want to admit that you’re not coping. You’re supposed to cope. You’re supposed to get on with life. I was diagnosed with post-natal depression and PTSD because of the SCAD. I would have periods of time where I was fine, then one day I’d drop Jacob off to kindy and I’d come home and panic because I kept thinking, ‘what if I have another heart attack now?’ It was really ruining me.”
Kerrie had monthly visits from a counsellor who talked things through with her and referred her to the Day Springs Trust in West Auckland, an organisation that helps mothers dealing with mental health issues.
“They were amazing. I’ve been blown away by how much support there actually is out there.”
Kerrie hopes that by telling her story she can reach other young women who might not have the confidence to speak out when something is wrong.
“Time is a healer. It’s taken me two years to be ok, but it’s changed my whole outlook on life. Everything is precious.”
Shared February 2019