Spontaneous Coronary Artery Dissection (SCAD)

A rare heart condition that can’t currently be predicted or prevented. Yet.

I am in the Acute Medical Unit… surreal.

I was brought up here about 3.30am last night/this morning – Gosh, the guilt at disturbing everybody in the middle of the night.

There are about 10 other patients, all of whom, except maybe 2? are at least 70 years old and, God bless them, they look as if they’re not long for this world.
Again, WTAF is happening to my life?

Plus, although the staff are wearing masks, none of us patients are. I haven’t been around this many people for nearly a year.
Never mind that there’s something wrong with my heart, but being so close to ALL THESE PEOPLE, is freaking me out no end.

However, the curtains are closed around me. Is this what happens at night time in hospital? Or are they trying to help me get to sleep like when we used to put a cover over the budgie’s cage at night time?

I am too wired, both mentally and literally to the machines, to be able to sleep. And it’s cold!

Also, the continual beeping from my monitor and the rest of the patients’, is a constant reminder that I mustn’t be very well. Eventually, instead of feeling freaked out every time the blood pressure cuff kicks in to action, (every 15minutes I think) I make friends with it.

The blinking, beeping and cuff-puffing, are looking after me.
Monitoring, protecting, looking after me.
New ‘pals’ in this mad, mad world, keeping a wee eye on my vitals.
But sleep was definitely not an option.

And anyway, I’ll be going home in the morning, I’m sure. I’m just in overnight so they can make sure that I’m stable.
(Well, as ‘stable’ as I ever was… !)
I’ll probs be sent home tomorrow, once the doctors have been round, with a few paracetamol.
A cup of Denial anyone?!

This morning, I feel quite chipper! You can’t say I’m not an optimist!
The beeping has taken on a metronomic effect and, although my chest pain is back, and with quite a vengeance I’d say, I do feel quite calm.

The staff are lovely. They were SO worried about what on earth they were going to find to give me for breakfast, once they realised that I was both gluten and dairy free!
There was such a level of quiet consternation about it, that I got up and dragged my new beeping, flashing buddy, through the curtains to reassure them.
“I don’t need anything, honestly! Please don’t worry!” (If you’ve read my Blasto Blogs, you’ll remember that I am very capable of not eating for a day or so. No problem)

In the end, one nurse thought that she should be able to procure a banana from somewhere.
“Grand!” I smiled, “That will be absolutely fine”. (Jilly still thinking that she will be toddling off home in a few hours anyway….) Calmness returned to the nurses’ station.

My man and I call each other.

“I’m fine!”, I say reassuringly. The doctors usually come round about 9.30/10am and I’m sure I’ll be sent home after that.”
(I mean it is a global pandemic isn’t it? They need the beds for the really ill people…)

“Cool!” Cameron says full of relief. “Work know I’ll have to leave about lunchtime, they’re being great about it and sending you their regards, so I’ll see you later!”
“Grand”, I smile as listen to him, “I don’t have any phone battery left, so I’ll text you once the doctors have been round, let you know when I’ll be out,” says Jilly-In-Denial and she eats her banana.

So I’m saving the remaining battery of my phone.
So no mindless browsing then.
No book.
Not much to do.

Except, I do keep coming back to the thought that I have been absolutely knackered for the last 3 months or so, which no amount of rest seemed to make any difference to.

As a close-contact service provider working in a Global Pandemic, the workload has been off the scale.
Massage therapists, beauty therapists, tattoo artists have been asked to adhere to an inordinate amount of regulations in order to be allowed to practise.

Very few of these regs. seem to have filtered through to the hospitals mind.
Nobody was following after me, once I had been to the loo; to disinfect the toilet seat, taps, handles, shelves, walls….
all of which I was being asked to do at work.
No member of staff was being castigated for not wearing their mask correctly.
But let’s leave that for another time…

And this infernal chest pain is back. Can I please have some more of that amazing injection and a few more of your ‘special’ tablets?!

Then I can go home.

I sit cross-legged, in the lotus position in the middle of my little bed. I can’t say that I’m meditating exactly, but I am practising calmness – there isn’t really much else that one can do.

A man in full scrubs (& mask!) approaches my bed.

“Hi!” I say eagerly. At last, I think. He’s going to give some paracetamol then I can get the hell out of this potentially, covid infected hell.
(The potential of catching covid is my main worry. I haven’t been this close to this many unmasked people in over a year for God’s sake!)
He smiles warmly over his mask.
Now.
The memory of the next bit is a bit blurry, so I’ll paraphrase.

Yip, I’ve had a heart attack – possibly 2. And, what he is most concerned about is that, whilst I have been in hospital, my enzyme levels have only continued to rise.

The enzyme troponin is an enzyme that the body produces in response to damage or death of heart tissue.

So whether my ECGs and all other levels were normal – this confirms it.
“We’ll get you on to a ward then you’ll go for an angiogram in the next day or 2” he explains.

Interestingly, what I hear is – I’ll go home and wait for a letter with a date for the procedure, then come back in.
Yea?
“No!” he sounds shocked, “you’re not going home Jill”.
“I’m not?”

My mind is suddenly incapable of functioning, moving so slowly as if through mud, whilst also, somehow, leaping around like the proverbial monkey mind.
Cameron!
No phone battery!
Smudge! (my cat who thinks she’s a dog)
Dad! (who will look after him?)
Mum! OMG, how on earth do I tell them that I’m in The Royal Infirmary?
What the actual F is going on?

My hand shoots up, clamping over my mouth as if trying to stop all of these thoughts from vomiting out of me, as big, fat tears of confusion and fear slip down my face.

The consultant becomes compassion personified.
“Are you alright Jill? I know it must come as a big shock”.
No shit! ya think?!

SCAD is when a tear or bruise develops in a coronary artery that prevents normal blood flow. This can cause a heart attack, heart failure, cardiac arrest and can be fatal.
Current data indicates:
90% of patients are female with an average age of 44-53, many of whom have no or few heart disease risk factors.
ECGs and O2 levels may be normal.
Assess troponin levels, repeating 4 hours later.
(NB. Results may be clinically insignificant)
For information:
https://beatscad.org.uk/what-is-scad/
https://academic.oup.com/eurheartj/article/39/36/3353/4885368