Have you ever heard of spontaneous coronary artery dissection or SCAD as it is referred to?
SCAD occurs when a split or separation suddenly develops between the layers of the wall of one of the blood vessels [artery] that provides blood flow to the heart.
The space between the layers of the artery wall may fill with blood, causing a haematoma, which may reduce or block flow through the artery; or a flap of loose tissue from the dissection may create a blockage.
If not diagnosed and treated quickly, SCAD may lead to a heart attack, life-threatening arrhythmias or sudden death.
Bomaderry woman Rachael Hall certainly hadn't heard of SCAD, but it has been the terrifying journey she has been on since early October.
Well-known locally for her involvement in a number of sporting and community organisations, as well as being the "Pink Postie", Rach, at 46, and the "fittest she's ever been" suffered a SCAD while camping with her partner George and son Jovan at Lake Conjola over the October long weekend.
"With COVID etc we'd been pretty busy, especially delivering parcels which I subcontract out to Australia Post for," she said.
"I hadn't had a holiday for ages and we were just having some time away, relaxing."
George and Rachael had been out fishing in their pedal propelled kayaks.
On the way back George broke one of his rudders and Rach, using her kayak towed him back to shore.
I thought I must have pulled a muscle or something while in the kayaks.Rachael Hall
"It was about two kilometres," she said.
"Nothing big, we took our time, I just pedaled, holding onto his kayak and got him back - it wasn't over strenuous."
The couple enjoyed lunch and then dinner, with Rachael noticing she had a bit of tightness in her chest and pain in her left arm.
"I thought I must have pulled a muscle or something while in the kayaks," she said.
Taking a shower in the caravan park's complex before "turning in for the night" Rachael's condition worsened.
"I had a really tight chest, was clammy and had tingling in my arm and pain in my back," she said.
"It just got worse.
"Luckily, there were two other girls in the shower area and I asked if they could get me some help and in particular George, who was showering in the men's section.
"The next thing I knew the girls had got their mothers and there were about eight women around me helping."
One of the women phoned the ambulance and they were advised to lay Rachael down and if someone had some, to give her aspirin.
"Thankfully one of the other ladies had some and went and got it," she said.
Ambulance paramedics arrived and it was thought she was having a heart attack - ECGs were taken and forwarded to doctors at Milton Hospital and then onto a cardiologist in Wollongong.
She was rushed to Milton Hospital, where Dr Lee Verrall and two nurses, both named Blake, administered specialised drugs for someone suspected of having a heart attack.
I had never heard of SCAD. It's pretty rare apparently and survival is about 30 per cent. My cardio rehabilitation nurse at Shoalhaven Hospital at Nowra says I'm only the second one she has seen locally in 10 years.Rachael Hall
Transferred to Shoalhaven District Hospital, before being taken to Wollongong Hospital she was eventually admitted to the coronary care centre but not before being told she was suspected of having "broken heart syndrome" which people can often get if they have been under lots of stress or have recently lost a loved one.
"I do have some medical knowledge, my mother and sister are both nurses and I hadn't had anything like that [losing a family member] so I knew it wasn't that," she said.
"I had also been diagnosed with a heart murmur years ago so I knew that was possibly also what they were picking up."
Being allergic to some pain medication, for four days she had nothing but panadol.
Meanwhile, glyceryl trinitrate, or GTN, which she had also been administered and which is used to treat angina [chest pain] gave her a migraine, of which she regularly suffers.
"Through all this, I was continuing to have chest pains and then battle migraines," she said.
"I was told they thought I might have a slight blockage."
An angiogram the following Tuesday revealed her "rare" condition with three stents put in place.
"It was only then I was told it was a SCAD - I had never heard of such a condition," she said.
"It's pretty rare apparently and survival is about 30 per cent. My cardio rehabilitation nurse at Shoalhaven Hospital at Nowra says I'm only the second one she has seen locally in 10 years.
"My mother has been a nurse in New Zealand for 40 years and never seen one, while my sister who is also a nurse has seen one but the patient did not survive.
"They can often be misdiagnosed and are the number one cause of heart attack in women under 50.
SCAD's can often be misdiagnosed and are the number one cause of heart attack in women under 50.
"So from that front, I'm very lucky."
Research shows, while it can affect men, SCAD mainly strikes women aged between 30 and 50.
"I really must thank the wonderful people who looked after me at Conjola Park, the ambulance paramedics who transported me and were fantastic, also Dr Lee Verrall and the great nurses at Milton Hospital. For a little centre, they were fantastic and I put my survival down to their early treatment," she said.
"This really came out of the blue. My family has no history of heart problems - there is nothing genetic. I consider myself fit, probably the fittest I have ever been, I'm only in my 40s - this shouldn't be happening."
Because SCAD mostly affects women with few traditional risk factors, awareness of and quick response to the warning signs of a heart attack is important advice for all women.
Rachael has now joined the Victor Chang Cardiac Research Institute and is part of a program helping with research into the disorder.
"We need to know more about SCAD," she said.
"I've also joined a survivors group on Facebook and we chat about the condition and any residual effects people have, or ask questions," she said.
"That has been a great help and support. As have all my family and a number of close friends.
"It's been tough, all my direct family apart from George and my boys James and Jovan and now my grandchildren, are in New Zealand and due to COVID they haven't been able to get here. Mum and Dad both wanted to come over for me but, of course, couldn't."
Although feeling better Rachael is yet to resume work and still feels tired.
She has had another brief stay in hospital with further chest pain, which was put down as "stent pain"
"My work has been fantastic, very understanding and supportive," she said.
And in true Rachael fashion, she is looking to get a local group together to help raise funds to continue the research into SCAD.
To that end, she will be organising a charity fundraising walk in the Shoalhaven, a SCADaddle next year. This year's event raised $100,000.
"I've spoken out to raise awareness of this condition," she said.
"I've been very lucky, I know that.
"We have to make sure research into this condition can continue."
More information on SCAD is available at SCADresearch.com.au or the SCAD Research Facebook page.
Or you can raise funds for SCAD Research Inc. each time you shop online at https://www.shopnate.com.au/cause/scad-research-inc.
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