I suffered a heart attack at 24 and I’m lucky to be alive. Experts still don’t know why so many young women like myself are suffering this deadly complication. But they have one theory…

When Courtney Bennett suffered a heart attack at the age of 24, she thought she was dying.

She had none of the typical risk factors and normal cholesterol levels when a crushing pain suddenly struck as she drove home from the supermarket in July 2024.

Doctors eventually discovered the cause was spontaneous coronary artery dissection (SCAD), a little-known condition that disproportionately affects younger women.

‘I instantly knew something wasn’t right,’ recalls Courtney, now 27, a brow and lash technician from Manchester.

She was admitted to hospital but after days without answers and as her symptoms began to ease, she discharged herself.

Within hours, however, the pain returned while she was washing her hair in the shower, forcing her to call an ambulance.

Over the following days, the chest pain came and went. Then, in the early hours of July 14, it suddenly worsened.

‘I woke up in pain in the middle of the night multiple times and the staff kept giving me pain medication,’ says Courtney.

‘Then, at around 9am, I took myself to the toilet and my body started emptying itself. I felt like I was dying.’

Courtney managed to get herself from the bathroom to her hospital bed. At the same time, the pain started down her arms and into her hands and she caught the staff’s attention.

‘I was crying my eyes out because I was in so much pain,’ she says.

She was taken urgently for an angiogram, a type of X-ray that uses contrast dye to show how blood flows through the arteries.

Doctors first tried to reach her heart through her wrist before using a catheter inserted through her groin.

‘I remember thinking, “I’ve got a child at home that I need to get home to”. I lost my mum when I was six, so I just thought history was repeating itself.’

The scan revealed a bruise in the wall of one of the arteries supplying her heart. The injury had narrowed the artery, restricting blood flow and triggering a heart attack.

Courtney was told she had suffered four ‘mini’ heart attacks over the course of the month.

But it was only after a fifth attack in hospital that doctors finally diagnosed SCAD. The condition is thought to cause at least four to six heart attacks every day in the UK.

Around 80 to 90 per cent of cases occur in women, and it is the leading cause of heart attacks in women under 50, pregnant women and new mothers.

Unlike traditional heart attacks, SCAD often happens to people without typical risk factors such as high cholesterol, smoking, obesity or diabetes.

Because it strikes out of the blue, it cannot be predicted or prevented. 

‘When they told me I’d had a heart attack, I couldn’t believe it,’ says Courtney, who was a non-smoker and was very active, both as an avid dancer and from running after a toddler.

‘I was thinking, “Why me? I’m literally 24 years old”.’ 

SCAD is usually managed conservatively without stents or bypass surgery because the torn artery wall can typically heal on its own over several weeks to months.

Following her diagnosis, Courtney was transferred by ambulance to another hospital, where she spent the next ten days recovering.

She was prescribed beta-blockers and aspirin to reduce heart strain and prevent blood clots while the vessel healed, which she has continued to take long-term to prevent another heart attack.

‘I found the idea of taking these medications for the rest of my life quite hard at first because I was sort of a person who didn’t take medication for anything,’ says Courtney. ‘It’s something I’ve had to get used to.’

There’s also the emotional impact of having a heart attack so young. 

‘I have a lot of anxiety that I’ll have another heart attack and it’s played a massive part in everyday life,’ Courtney says. 

‘For example, I’ve danced since I was two years old and even though my doctor said I could start dancing again 12 weeks after the heart attack, I’ve still not gone back. 

‘It’s that constant worry of “what if it happens again?”‘  

The symptoms of SCAD are usually the same as those of a heart attack. Chest pain is the most common symptom, although some patients also experience pain in the back, neck, jaw or arms, particularly the left arm.

The key tests are a heart trace called an ECG and a blood test called troponin, which will often need to be checked twice over some hours.

Experts stress the importance of staying in hospital until these tests are completed and you have the results.

While the exact cause of SCAD is not known, Courtney’s doctors told her a combination of hormonal changes and stress likely triggered it.

Scientists believe changes in female hormone levels may help explain why some women develop SCAD. 

The hormones oestrogen and progesterone can affect the structure of artery walls, potentially making them weaker and more prone to tearing.

Courtney also has endometriosis, a condition in which tissue similar to the lining of the uterus grows outside the uterus, most commonly on the ovaries, fallopian tubes and pelvic lining.

Some studies have suggested that women with endometriosis may face a higher risk of cardiovascular disease, although researchers are still investigating the reasons for this link.

Professor David Adlam, a cardiologist and SCAD specialist, said he has not seen a clear association between endometriosis and SCAD, although there are no specific studies to report.

Because endometriosis is relatively common, he said, the two conditions may occur together by chance.

He also says evidence has shown no association between SCAD risk and hormonal contraception or hormone replacement therapy, while noting that the evidence is relatively limited.

‘SCAD is a completely different disease to the condition most of us are familiar with as the cause of heart attacks,’ he says.

‘It is not linked to many of the risk factors associated with conventional heart attacks and seems to particularly affect women.

‘This likely tells us something about the underlying causes of SCAD.

‘We know SCAD occurs in some women late in pregnancy or shortly after childbirth and otherwise peaks around the menopause.

‘This suggests there may be a link between SCAD and changes or fluctuations in sex hormones but exactly how this works remains to be fully worked out.’

He says most postpartum SCAD usually occurs in the first six months, most frequently in the first month after delivery.

‘This probably relates to the changes occurring in a woman’s body, and blood vessels in particular, due to the hormone changes after birth,’ he says.

‘But we don’t yet fully understand how this contributes to the risk of SCAD in some women. This is a focus of our BHF, NIHR and Beat SCAD funded research.’

One theory is that pregnancy-related hormonal changes could contribute to vulnerability in some women, possibly alongside genetic factors, but the mechanism is not yet understood.

While he cannot comment on individual cases, Professor Adlam says a heart attack occurring more than a year after childbirth would not generally be considered pregnancy-associated.

He also stresses that SCAD in a woman in her twenties is unusual, as the average age of patients is in the early fifties.

The good news is that most people who experience SCAD have a very good physical recovery, with most torn coronary arteries healing on their own within three to six months. 

Courtney’s advice to others is simple: ‘You are never too young to have a heart attack.’

For more information on SCAD, visit Beat SCAD.