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Unraveling the mystery of SCAD

A northeast Iowa woman is part of a study that’s helping unravel a rare heart condition that strikes young, otherwise healthy people. 42- year- old Tracy Hjelle (YELL-ee)  is the picture of health, she’s athletic and is in great shape, that’s because she’s the pitching coach for the Luther College softball team, but her world turned upside down on a Sunday morning in April as she and the team were preparing to leave Decorah for a game in Wisconsin. She says ,“As I was going into the building with one of the players, she said she held the door back for me and before she knew it the door had hit her hand and  she realized that I didn’t catch it and then she heard me hit the pavement.  I had no symptoms that I can remember up to that point, I don’t recall not feeling well even in the days  before then , things were pretty normal.”

Hjelle was stabilized and flown to the Mayo Clinic where she was diagnosed with what cardiologist Dr. Sharonne Hayes calls SCAD. She says “well SCAD is an acronym for spontaneous coronary dissection and it is an uncommon and probably under diagnosed cause of heart attack and death. And it’s when instead of plaque building up in the artery, the layers of the artery actually split and either a clot or a flap of the artery is split away and blocks the artery causing a heart attack.”

Hayes and her colleague Dr. Rajiv Gulati  are doing research to uncover clues about SCAD, including potential risk factors,  short and long-term recovery and the rate of reoccurrence. Gulati says “there are number of patients that a year ago, we would  have said this is a typical cholesterol heart attack based on the angiogram, but now with these newer tools,  we’ve found no plague, no cholesterol build up,  but a dissection within the vessel wall,  so I think this is under recognized and that’s an important aspect  going forward here.”

Another aspect of going forward is with the patients themselves. Dr. Hayes explains that researchers have gone online to create a registry and a DNA bio bank for SCAD patients and their families, and  she says ,"we used the internet and social media to identify them and to allow them self identify and now they are filling out an extensive array of questionnaires so we can understand their medical history to see if we can find some clues to the cause and best treatments .”

As for Tracy Hjelle, she’s preparing for the fall semester. She’s extremely lucky because in many SCAD cases, patients either die before help arrives or suffer irreversible damage. “ My recovery has been pretty good, everyone was just amazed that I was back around in town . In a week I was out and about somewhat normally. It was due to the fact that I didn’t have surgery or anything invasive done, I went through a lot of testing:  CT scans and MRIs afterwards, too, just to monitor. They’ve just been watching the progress, let my body take over.”she says.

Tracey’s husband John credits her swift recovery to the fact that his wife was surrounded by people who had been trained in CPR and that Luther College has defibrillator devices available on campus. He says “the AED device was only 20 paces away and within seven minutes they had her back in normal heart  rhythm because  without those pieces in place, she wouldn’t be as normal as she is today and my life would have been turned upside down.” 

The Hjelles are now heading up efforts to get more devices placed in schools and other public places throughout Northeast Iowa


Pat Blank is the host of All Things Considered