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She Had Two Heart Attacks, but Normal Arteries. What Was Going On?

She Had Two Heart Attacks, but Normal Arteries. What Was Going On?

The 56-year-old interior designer was at her desk, on the phone, when the now-unmistakable burning ignited her chest. Since her heart attack the year before, the pain, which her cardiologist called angina, would hit her at the strangest times. Just sitting or even sleeping, she’d get this sensation like terrible heartburn. She quickly got off the phone, knowing what was coming next — the rib-crushing pressure that made it hard to talk or even breathe. She made her way to the kitchen and bathroom, looking for nitroglycerin, the only medicine that relieved the pain. She couldn’t read the labels on the pill bottles — that’s when she knew she was in real trouble. She could feel her heart beating erratically as she called 911. She collapsed before she could even unlock the door.

The next thing she knew she was at eye level with a dozen workmen’s boots. I need nitroglycerin, she croaked. Far away, she heard the clipped, crackly syntax of walkie-talkie’d instructions. She was lifted onto a stretcher and jostled to an ambulance before she felt the relief from the sliver of nitroglycerin slipped under her tongue. The weight on her chest lightened. Within minutes, she was rolled into the E.R. of HonorHealth Medical Center in Scottsdale, Ariz. “We think you’re having a heart attack,” a stethoscope-draped man told her.

It was all horribly familiar — a rerun of an episode 15 months earlier, when she was with her family in River Vale, N.J. Back then, the burning pressure sent her to the emergency department, and she was told the same thing: She was having a heart attack. Immediately the cardiologist looked for blockages in the coronary arteries, which feed blood and oxygen to the hardworking muscles of her heart. That was the cause of most heart attacks. But they found no blockage. She’d had a heart attack, the doctors said, but it wasn’t from atherosclerotic plaques narrowing her vessels with layers of fat and crust. Instead, a spasm squeezed her coronary arteries so tight that she couldn’t get sufficient blood through them to power her heart. When the spasm passed, the arteries reopened, and blood flow was restored.

She told the doctors in the Scottsdale E.R. that when doctors looked at the arteries in her heart before, they hadn’t found any blockages. But the Scottsdale doctors still took her to the cardiac-catheterization lab. The lack of blood flow was causing her heart to beat erratically. Getting rid of a blockage, if she had one, would save her heart muscle and maybe her life. Again, when they filled her arteries with the contrast, they found no blockages.

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