You are a healthy young woman who exercises regularly, eats well and has never had any signs of heart disease. You don’t have to worry about a heart attack, right? Wrong! There is a condition called spontaneous coronary artery dissection (SCAD) and it is the number one cause of heart attack in women under 50, pregnant women and new mothers. Intense physical activity, emotional stress, hormones, and cocaine use can also increase the risk. In a recent trial, more than half of those women who experienced SCAD had an emotionally or physically stressful event around the time of their attack.

Traditional heart attacks are caused by blockages due to atherosclerosis (hardening of the artery) or plaque build-up in the arteries supplying the heart. In SCAD, there is a tear in an otherwise normal artery. This flap of tissue can block blood flow, or lead to formation of clots.

Symptoms of SCAD include chest pain or heaviness, fluttery heartbeat, excessive sweating, nausea, dizziness, and shortness of breath. In some women, these symptoms can be ignored or misdiagnosed. For example, a sudden onset of back pain following exertion in a young healthy woman might be thought to be musculoskeletal and treated with anti-inflammatories. The condition could worsen leading to cardiac arrest. This is why it is important for younger women to recognize the symptoms and know their risk factors.

The initial treatment of SCAD is conservative: medications to lower blood pressure, control heart rate and reduce the risk of clots. If the tear is severe, in multiple arteries or in certain major arteries, more aggressive treatment like angiography or a coronary artery bypass graft (CABG) may be necessary.

So if you are a young woman, or know one, make them aware of SCAD. Heart disease is not limited to middle aged, overweight-pack-a-day men who list fast food as one of the four food groups. It can affect healthy young mothers who exercise and eat well.

Take care of yourselves and each other.