Missy Lavintman: Spontaneous Coronary Artery Dissection

At age 65, Missy Lavintman considered herself to be in great shape. She was a lifelong exercise enthusiast, mother of five children, and was actively working multiple jobs as a schoolteacher and program leader for Weight Watchers. Missy figured that she was completely healthy, and explained, “I didn’t know what it was like to be ill.” This all changed in April of 2018.

Missy began experiencing occasional symptoms of acid reflux, and a few weeks later while working at the school she became out of breath after climbing three flights of stairs. While this was highly unusual for her, she chalked it up to being tired. However, the next day her symptoms persisted. While two of her children were over for dinner, she began telling a story, but became terribly out of breath

before she could finish. When her daughter expressed concern, Missy again justified her symptoms as being tired. She knew that something wasn’t quite right, but held off going to the doctor. Her husband made the decision for them to go to Urgent Care that evening and Missy drove.

The staff at urgent care performed a blood test, which revealed elevated levels of troponin — a biomarker of heart attacks. Suspecting that something was seriously wrong with Missy’s heart, the medical staff insisted that she be seen by the cardiologists at the Minneapolis Heart Institute® at Abbott Northwestern Hospital.

First, she had an angiogram procedure — where dye is injected into the heart’s arteries to look for blockages. The angiogram initially showed normal arterial flow and the medical staff felt comfortable moving her to a normal patient room to rest, but something still wasn’t quite right. Her nurse explained that Missy didn’t seem like she was feeling healthy enough to be moved, and insisted they continue to monitor her heart via an EKG machine. Fortunately they did, because doctors soon discovered that Missy was experiencing a particularly dangerous type of heart attack called STEMI (ST-Elevation Myocardial Infarction).

Cardiologists performed another angiogram, this time the results revealed a tear in her right coronary artery blocking blood flow to nearly one-third of her heart muscle. Missy was diagnosed with Spontaneous Coronary Artery Dissection (SCAD), an increasingly recognized condition which occurs when there is a spontaneous tear in an artery that is apparently healthy. The causes of SCAD are uncertain, it is not related to cholesterol buildup. Nearly 90 percent of SCAD patients are women — it is the #1 cause of heart attack among younger women. SCAD is especially dangerous when it occurs during pregnancy or at the time of childbirth. SCAD treatment requires special expertise because of the fragile nature of the involved coronary artery.

In an emergency procedure, doctors at the Minneapolis Heart Institute® successfully restored blood flow in her right coronary artery with several stents. Missy experienced several complications due to arterial bleeding and acute heart failure. She eventually received a ventricular assist device — an implantable mechanical circulatory device that helps pump blood.

After about a month-long hospitalization, her condition improved enough to allow further recuperation at a transitional care facility along with in-patient rehabilitation. After a few setbacks, she returned to home!

After reflecting on her experience, Missy said she has learned to be an advocate for her health, to pay careful attention to her body, and to promptly seek professional care if something feels “off.” She is grateful to be alive and is thankful to everyone who helped during trying times. Her advice to other women: “If we can’t take care of ourselves, we will not be able to take care of anyone else.”