Morris woman takes part in Mayo Clinic heart study
By Jeanne Millsap For The Herald-News July 24, 2012 11:56AM
Cheryl Crisman is back in the swing of things with her children, Samuel and Saral, and husband Paul after a 2008 heart attack. She is currently paricipating in a Mayo Clinic research study. | submitted photo
Updated: August 26, 2012 6:05AM
MORRIS — No one would have dreamed a young mother of two, Cheryl Crisman, was about to suffer a major coronary event one afternoon when she wasn’t feeling very well. It was Super Bowl Sunday 2008, and Crisman and her family were getting ready to go to a party at a friend’s house.
“I hadn’t really felt good that Friday and Saturday,” Crisman said. “I just felt so lethargic and a heaviness. I really thought I had the flu.”
She told her husband she was going to run over to the emergency room to get checked out, thinking they would give her some Tamiflu for her symptoms. She drove herself. It was nothing, she thought, but she wanted to get a handle on whatever it was before the upcoming work week.
But when a nurse came in her ER room after a few initial screenings with a nitroglycerine tablet for Crisman to put under tongue, the scenario changed.
“We think something is wrong with your heart,” Crisman said the nurse told her.
“It was kind of surreal,” Crisman said. “The next thing I remember was waking up in the cath lab.”
A lucky turn of events
Crisman was having a heart attack caused by a spontaneous coronary artery dissection, or SCAD. She said the only thing she remembers was them telling her they had put a pump in to keep the blood going while she was rushed to another facility.
She later found out she was lucky she was in the ER when the event occurred. Many who have a SCAD event die suddenly from cardiac death or an arrhythmia.
“SCAD is clearly one of the most common causes of heart attacks in women younger than 45,” said Dr. Sharonne Hayes, a Mayo Clinic cardiologist and SCAD researcher.
Crisman is participating in a SCAD study being performed by Hayes.
There isn’t a lot known about SCAD, Hayes said, and many ER physicians and cardiologists treat it just as they would a regular heart attack. But that may not be good enough.
Every artery has multiple layers, she explained, and a SCAD occurs when there is a split between two of those layers in an artery in the heart. That can result in a tear, where a loose flap blocks the artery. It can also cause a clot in the artery or bleeding between the layers causing a kind of hematoma.
Symptoms can include sudden chest pain, either from the tearing itself or from the blockage of blood flow to the heart.
Link to pregnancy hormones
SCAD usually occurs in otherwise healthy people ranging in age from 30 to 50, although Hayes said she has seen it occur even in teenagers. It occurs more often in women than men, and they have no obvious risk factors as do those who suffer regular heart attacks.
Pregnancy hormones may play a role, though. About 30 percent of SCAD cases affecting women occur during late pregnancy or shortly after birth.
“We believe there is a link between pregnancy hormones and SCAD,” Hayes said. “There are estrogen receptors in every blood vessel.”
A theory is that the hormone fluxes with pregnancy may be a contributing factor. Crisman’s attack occurred about four months after she delivered her second child. She ended up having emergency bypass surgery and is now fine. She jumped at the chance to be a part of Hayes’ study.
“I have a daughter,” she said. “I don’t want anyone else, especially my daughter, to have to go through this. . . Also there is no standard form of treatment. Some people get bypasses, and others are being medically managed. There’s nothing to connect us all yet.”
Getting to the bottom line with SCAD is what Hayes’ research is all about.
“We are developing a virtual registry and DNA biobanks,” Hayes said, “to better understand the genetics and predisposing factors. . . We will follow several hundred men and women.”
For further information about the study, email mayoscad@mayo.edu.
