February is heart health month and I am SO EXCITED about it. But not for the reasons you may think. In the past, I have let this month go by like every other month of the year. That changed on August 30th, 2022, the day I had a heart attack. You might be thinking, “What??? Dr Litty had a heart attack?” Or maybe you are thinking, “She should listen to her own advice and eat more vegetables and exercise.” You might even be wondering “What can I do to strengthen my heart and prevent heart disease?”
My heart attack was caused by a condition called spontaneous coronary artery dissection or SCAD. It happens when the inside lining of a vessel in your heart pulls away from the vessel wall and creates an alternate, dead end path for blood to flow that diverts blood flow away from the real vessel and causes a heart attack. SCAD typically occurs in young (40-50s) otherwise healthy women. Risk factors include female gender (though it does happen in men too), pregnancy or recently delivered, and women in their peri/post-menopausal years. It is thought to be caused by significant shifts in hormones, emotional stress and in men heavy lifting. The presence of a condition called Fibromuscular Dysplasia or FMD, significantly increases risk as it causes a weakened endothelium (the lining of vessels). Often, however, a cause is never found.
Symptoms are similar to those of a heart attack caused from atherosclerosis but recall in women, these may be atypical and present as fatigue, nausea and shortness of breath instead of classic left sided chest pain radiating down the left arm. It is often undiagnosed, putting SCAD sufferers at increased risk for long term consequences and death.
So what do I think caused mine? While the doctors could not tell me and my tests to find a cause were all negative (thank God), I believe my SCAD was caused by significant stress, poor sleep and heavy lifting. There were many things going on in my life at the time that I was not managing as well as I thought.
Stress management is so important and often we overlook it as a significant cause of illness. Our bodies natural response to a stressful situation is to make and increase cortisol (the stress hormone) which increases blood sugar so that you can deal with whatever stressful situation you are in. After the situation resolves, the levels drop and you move on. But with chronic stress or unresolved trauma, these levels stay elevated which contributes to weight gain, cardiovascular disease, high blood pressure and diabetes. It can also lead to other hormones being off as all the hormones interact with each other.
To control stress and cortisol levels we recommend several things.
First, if one can change the amount of stress one is exposed to daily, change it. For some this means changing jobs, for others perhaps learning to say no and not overextend yourself.
Second, practice stress reducing exercises like diaphragmatic breathing and grounding (walking in nature barefoot, foresting etc). Humming, singing or aggressive gargling can also trigger your parasympathetic nervous system which is the system that helps us relax. Prayer, meditation and mindfulness can all help with managing stress as well. Learn to find joy in the little blessings given to us and perhaps keep a gratitude journal.
Third, optimize gut health to ensure the proper detoxification and elimination of hormones.
Finally, make sure that good sleep is prioritized. If we start the day off with great sleep, we set ourselves up for success with handling the things that life throws at us.
So how am I now? I am exercising more regularly. I significantly reduced my intake of inflammatory foods and I aim for 7-8 hours of sleep at night. Though many of my stressful situations have not changed (because that is life) I am able to deal with it better. Life is good!!
-Dr. Litty
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