Sudi’s story: A heart attack out of nowhere

New research will help doctors diagnose and treat a potential killer
Sudhi portrait

Sudi Barre

Sudi Barre was in hospital with her newborn son, recovering from an emergency caesarean, when pain suddenly ripped through her back and arm. It was a heart attack that she would later learn was caused by spontaneous coronary artery dissection (SCAD). It’s a frightening and potentially fatal condition where the heart’s artery walls start tearing apart.

Implanting a stent only led to more heart attacks. When Sudi’s heart function plummeted to just 3%, doctors implanted a mechanical pump. Sudi spent the next eight months in hospital, her chest criss-crossed with scars, too weak to hold her son. But she kept going for his sake.

“I wanted the gift of life and motherhood,” she says. “I wanted the energy to run around with my baby when he started walking.”

Dr Jacqueline Saw

We were actually missing a lot of SCADs. We did not have the right tools.

Dr. Jacqueline Saw Heart & Stroke researcher

Eighty-eight per cent of SCAD patients are women, many young and otherwise healthy. In most cases, they have no traditional risk factors for heart disease and no warning signs. And when it happens, SCAD is often under-diagnosed because it can be difficult to detect on traditional angiograms.

“I’ve seen so many horror stories,” says Dr. Jacqueline Saw, Canada’s leading expert on SCAD. 

Young women are often turned away from emergency rooms, despite heart attack symptoms, because they’re in their 30s or 40s. In other cases, like Sudi’s, it’s treated like a standard heart attack. But stents or blood thinners can actually increase the risk of further tearing.

“We were actually missing a lot of SCADs. We did not have the right tools for diagnosis in the past,” says Dr. Saw.

Dr. Saw has developed a classification to analyze angiograms that will help doctors detect SCAD. She and her team at the University of British Columbia are also following more than a thousand patients, tracking everything from what triggered their heart attacks to the effectiveness of treatments. With support from Heart & Stroke, her team has identified genes that increase the risk of developing the condition.

SCAD accounts for about 35% of all heart attacks in women under 50.

Today, Sudi struggles with forgetfulness, and little things can make her irritated or upset. “I’ve just become an emotional mess,” she says, laughing. However, she lives life with as much joy as she can muster. Surgeons have removed her mechanical pump, and her heart is functioning at 40%: enough to finally cuddle with her son. 

As a heart health advocate, she’s speaking up about her experience because she wants more healthcare professionals to recognize SCAD. 

According to Dr. Saw, that day is close. Within the next five years, she expects to see genetic screening tools, much better rates of diagnosis by health professionals and better protocols for treating the disease. “We’ve come a long way,” she says.

2020 Spotlight on Women

Research is starting to close the sex and gender gap.