A healthy lifestyle protects against many diseases. But even those who eat a balanced diet and get enough exercise are not immune to a heart attack. The German Heart Foundation is now warning about this: “Hardly any risk factors and still have a heart attack? This is often the case with spontaneous coronary artery dissection,” says the portal’s website, where experts warn of this “dangerous tear in the heart.” Younger women are particularly affected by this.
“Tear in the heart” – this is a coronary dissection
During a coronary dissection, individual wall layers of a coronary artery split. This happens through two mechanisms:
Tear in the inner skin (intima) of the vessel. Burst (rupture) of a small vessel in the vessel wall
“Under both circumstances, bleeding occurs into the vessel wall and, as a result, an accumulation of blood (hematoma, bruise),” write the experts. “This bruising then causes the interior of the vessel to narrow and normal blood flow to be hindered. This leads to an insufficient supply of blood and oxygen to the heart muscle (ischemia) or, if the vessel is completely blocked, to a heart attack.”
The striking thing about it: The vessel wall is not damaged by atherosclerotic deposits (plaques).
The dangerous thing: The crack spreads particularly widely here due to an often weakened but plaque-free, smooth wall structure.
Symptoms: This is how the crack becomes noticeable
The most common Symptom is pain in chest.
In 30 percent of cases it comes to one Heart attack.
In 70 percent of cases it comes to one acute coronary syndromei.e. an acute circulatory disorder.
The clinical picture of Acute coronary syndrome includes the immediately life-threatening phases of coronary heart disease:
As a result of the circulatory disorder, it can also life-threatening cardiac arrhythmias occur in the ventricle. In very rare cases it can even… sudden cardiac death come.
Frequency: Mainly two groups affected
Overall, a coronary dissection is a rare cardiac event, writes the Heart Foundation. Acute coronary syndrome accounts for around one to four percent of heart diseases. However, the number of unreported cases is high because the diagnosis is often not made – and therefore therapy may begin late. In most cases, the diagnosis is only made during the autopsy.
Because: Coronary dissection accounts for the majority of cardiac deaths in young people, writes the “Doccheck” portal. Studies also show that sudden cardiac deaths in young people are often due to this.
The average age is between just 25 and 35 years, which is atypical for heart disease. The Heart Foundation points out that two groups in particular are more frequently affected:
Young heart patients who do not otherwise have any cardiovascular risk factors. Around one in three women under the age of 50 with acute coronary syndrome are said to have a coronary artery dissection as the cause. Women during or shortly after pregnancy
Cause: This is how the crack in the heart occurs
The most frequent Caused is the so-called fibromuscular dysplasia of the coronary artery. This is a defect in the vessel wall at the point where the “tear” later occurs.
The Heart Foundation also points to hormonal influences that weaken the inner wall of the blood vessel. These include:
Pregnancy (here hormones interact with the increased vascular strain, for example through increased blood volume) Infertility treatments, postmenopausal hormone therapy and oral contraception.
In addition, diseases of the connective tissue and chronic systemic inflammatory reactions can be the cause.
How to protect yourself
If trigger says the Heart Foundation:
intense psychological stress extreme physical stress (e.g. static strength exercises or pushing during childbirth) drug abuse with cocaine, amphetamines and methamphetamines.
So, in addition to your physical health, you should also take care of your mental health. For example, avoid severe stress and seek help if you are under severe psychological stress.
When it comes to strength training, it is important not to overdo it; beginners in particular should increase weight and training slowly.