In April 2018 Shirley Ingram, a specialist heart nurse in Tallaght Hospital in Dublin, was running on the treadmill in the gym before work. Little did she know that just two hours later she would indeed be in Tallaght Hospital, not to start her day as a cardiac nurse, but rather in the Emergency Department being treated for a heart attack.
Shirley from Dublin recalled the morning in April 2018 when she was attending her regular gym session and suddenly began to feel unwell.
She had no chest pain, but she did have pain in both her shoulders and a burning discomfort in her throat. Both her arms also felt tight and she instinctively knew she was in serious trouble.
If it wasn’t for her 30 years’ experience as a specialist cardiac nurse, Shirley would have perhaps dismissed her pain as simply overdoing it at the gym.
" I didn’t believe I was having a heart attack; I knew I was having a women’s heart attack,"
A fit active woman who had just turned 50, Shirley had none of the common risk factors for heart disease. She was not overweight, she never smoked, and her blood pressure and cholesterol were normal.
“I felt a funny sensation in my left shoulder tip, and I thought I had another muscular injury, I will just keep going and see how it is. Then I felt another sensation in my right shoulder tip. I always remember one of the doctors in work saying if you see bilateral (in both shoulders at the same time) shoulder pain always be concerned,”
“I also had a general sense of unease but I just kept going and within a minute or so I started to get this feeling on the right side of my throat, this burning discomfort feeling and then I just knew instinctively that something was wrong. I stopped running, I didn’t feel unwell in any other way. I went to the mats and did some stretches, but nothing was helping. I just felt in my bones that this was not right and then both my arms from the elbows to the hands became tingling and tight.
I sat there on the mat and I said to myself, “Shirley this is what women feel like when women are having a heart attack.” That was the first thought that came into my head.”
Shirley’s instincts proved right and just a short while later she was in the Emergency Department in Tallaght where her concerned colleagues rallied to care for her.
An ECG confirmed Shirley was having a heart attack and she was rushed in for a coronary angiogram which diagnosed a narrowing in the right coronary artery.
" I sat there on the mat and I said to myself, 'Shirley this is what women feel like when women are having a heart attack.' That was the first thought that came into my head.”
Shirley suffered a Spontaneous Coronary Artery Dissection or SCAD.
SCAD is an uncommon emergency condition in which a ‘tear’ happens within the layers of the wall of the artery. This leads to blood becoming trapped within the artery, forming a clot and causing a partial or complete blockage. This can lead to a possible heart attack, an abnormal heart rhythm or even sudden death, if not treated promptly.
Researchers are not fully sure what causes SCAD, but it is known that 80 per cent of sufferers are women and 30 per cent of those are nearing the end of a pregnancy or have recently given birth. Like Shirley most people with SCAD are otherwise healthy and might not have any risk factors for heart disease. It tends to occur in people between the ages of 19 and 64.
Once Shirley’s coronary angiogram was over her physical symptoms immediately improved but it took some time for the shock and emotional scars to heal.
“For me it was the shock. One minute you are running on a treadmill and two hours later you are lying on your back being told you have had a heart attack… It took me a good 6 weeks before it really hit me,” Shirley said.
“For me it was the shock. One minute you are running on a treadmill and two hours later you are lying on your back being told you have had a heart attack... It took me a good 6 weeks before it really hit me,”
The main emotions Shirley felt in the weeks after her frightening experience were shock and denial. However, she said she found real solace and support from the Irish Heart Foundation’s SCAD Support Group. As a member of the support group Shirley is working to raise awareness of SCADs as a cause of heart attack in young, fit, low risk men and women.
The SCAD Support Group aims to support those affected and increase awareness of the condition among the medical community. It also works with Irish and other European experts to ensure that all those diagnosed with SCAD receive prompt and appropriate treatment and an equal standard of care.
Shirley said she would encourage anyone affected by SCAD or indeed a serious heart condition to join one of the Irish Heart Foundation support groups.
“ I have been working in cardiac nursing for 30 years, I thought I knew it all. But when it comes down to yourself, then you realise you can’t do it all on your own and you don’t know it all,” Shirley said.
Today Shirley is thankfully back to full health, she has returned to work and is also back running and at the gym.
" Professionally this is not easy, but I feel a responsibility to share my story."
“I think it’s important for women that we look after ourselves. We are great at looking after everybody else. We are child rearing; we are looking after elderly parents.”
“I didn’t get through all of this alone. I have a fantastic husband and children and it took its toll on them as well, but we need to look after ourselves so that we can continue to look after the family,” Shirley added.
Shirley is passionate about raising awareness of the importance of heart health both through her job but also now, as a result of her own personal experience. She also firmly believes that her job saved her life.
“I didn’t have any chest pain. I didn’t have the ‘TV’ heart attack. I didn’t collapse, I didn’t go unconscious, I did not have chest pain, none of these things happened to me, but my heart muscle was dying. I didn’t think I was having a heart attack; but I knew I was having a women’s heart attack because women’s symptoms can be different. Professionally this is not easy, but I feel a responsibility to share my story. I want to encourage women to look after their lifestyle and if they feel unwell to get themselves to the Emergency Department. Because If it could happen to me, it could happen to anybody.”
