Brenda Creighton had just gotten home from work on a Friday evening in 2018 when she felt an immediate tightness and tension in her chest. The 45-year-old mother of two had no history of cardiac issues and had recently visited her primary care provider, ensuring she was in great health.
The pain in her chest continued and traveled down her left arm. And then the base of her neck and skull began to ache.
Creighton took an aspirin and laid on her left side, hoping the pain would subside. When the symptoms continued, she called her husband and her sister.
“We probably should have called 911,” Creighton said. “But I just didn’t think it was super serious.”
Her family drove her to Gundersen St. Elizabeth’s Hospital and Clinics in Wabasha, Minn. By then, the pain in her chest and arm subsided, leaving a lingering ache in the back of her head and neck.
The Emergency Department team at Gundersen St. Elizabeth’s started an EKG and ran tests to determine what was causing Creighton’s alarming symptoms.
Preliminary results showed a cardiac issue. Following protocol, the ED team transferred Creighton to a larger tertiary care center in Eau Claire, Wis.
“I was joking with the transport team, telling them I was probably fine,” Creighton said.
She was admitted to the cardiac floor in Eau Claire. Blood tests were drawn and a stress test was scheduled for the next morning. Creighton was told to get some sleep.
But at 2 a.m., everything changed.
“All of a sudden, specialists and nurses burst into my room,” Creighton said. “They were very concerned about my health.”
Creighton’s lab numbers were elevated. Staff rushed her to an exam room with diagnostic equipment that helps discover cardiac abnormalities.
“I cried as they were wheeling me to the cath lab,” Creighton said. “I was like, ‘This is the real deal. This is scary.’ It was really emotional.”
While she doesn’t remember much about the procedure due to conscious sedation, Brenda remembers what happened after. Her cardiologist explained that she experienced a spontaneous coronary artery dissection (SCAD) heart attack.
Warangkana Chokesuwattanaskul, MD, FACC, interventional cardiologist at Gundersen in La Crosse, said SCAD most commonly affects women in their 40s and 50s and happens when a tear forms in a blood vessel in the heart.
“People who have SCAD often don’t have risk factors for heart disease, like high blood pressure or diabetes,” Dr. Chokesuwattanaskul said.
Because a stent could cause more tearing, Creighton’s cardiologists let her recover naturally and manage her condition medically . She was discharged on Sunday and returned to work Monday. For the next two years, she took medication, participated in Cardiac Rehab at Gundersen St. Elizabeth’s and met with her cardiologist a couple times a year.
But in June 2020, she had an onset of the same symptoms – tension in her chest, tingling in her left arm and an aching in her neck. This time Gundersen St. Elizabeth’s Emergency Department transferred her to a tertiary care center in Rochester, Minn., where she underwent diagnostic tests.
There she received an answer: she has fibromuscular dysplasia, or FMD. FMD causes narrowing and enlargement of arteries in the body. Narrowed arteries can reduce blood flow and affect organ function. The association between FMD and SCAD has been reported but is still being researched. Medications help, but there’s not a whole lot more Creighton can do about her condition.
Wah Wah Htun, MD, interventional cardiologist at Gundersen in La Crosse, encourages people who’ve had SCAD heart attacks to share their experiences.
“I encourage my patients to focus on coping with the diagnosis rather than learning how to fix it,” she said. “There are several patient alliance forums where survivors can share their stories and feel connected with others who’ve had similar experiences.”
Creighton has learned how to cope with her diagnosis in part by wearing a heartbeat necklace, a visual reminder to her and others of what she’s been through. Recently Creighton joined the team that just a few years ago helped save her life. In December she accepted an HR role at Gundersen St. Elizabeth’s in Wabasha.
Creighton said, “Working for the organization that played such a role in my own life is pretty awesome.”
Your health
Drs. Htun and Chokesuwattanaskul encourage all women, whether or they have a cardiac health history or not, to prioritize their health.
Find ways to relieve stress
Chronic stress can lead to inflammation in the body which is a major contributor to heart disease.
“All of us experience stress. The goal isn’t to avoid stress but rather find ways to relieve it,” Dr. Htun said.
For Dr. Chokesuwattanaskul, her patients help sustain her energy level and optimism.
“I often visit with patients who’ve had life-changing or life-altering cardiac experiences. They’re still smiling and laughing. It’s quite inspirational,” she said.
Have a primary care provider on your team
Drs. Htun and Chokesuwattanaskul refer to a primary care practitioner as the gatekeeper of your health. They’re aware of your risk factors, history and health goals and can help determine which tests and screenings are appropriate and when.
“Primary care providers see their patients holistically,” Dr. Chokesuwattanaskul said. “Through regular screenings and well checks, they can help detect health issues before they turn into more serious concerns.”
Know your numbers
Keep track of your numbers, Dr. Htun says. Know your BMI, weight, blood pressure, etc.
Eat healthy – in ways that work for you
Dr. Htun encourages her patients to pay less attention to the name of the diet – Mediterranean, DASH or Keto – and instead, focus on what’s sustainable for you and your lifestyle.
“Find ways to incorporate fruits and veggies, low fat dairy and lean meat in ways that work for your day-to-day schedule,” she said. “Try to avoid saturated fat, added sugar and too much salt.”