Carol Poole was nearing the end of her weekend shift as a heart catheter technician at Prisma Health’s Greenville Memorial Hospital when she began to feel hot.
She felt flushed and began sweating profusely. Then came the nausea.
She thought she’d eaten something that disagreed with her. She thought she could power through it.
As part of a team doing the critical work of helping save the lives of heart attack patients, she thought “scrubbing out” and taking a break would be letting her team down.
But her teammates took charge and convinced her of a fact women all too often have trouble admitting: she was having a heart attack.
‘Women deny’
Speaking of her experience the night of April 5, 2025, Poole said for the longest time as events unfolded she didn’t understand what was happening to her.
“I was nauseated. The pain was not chest pain. It felt like something else,” she said. “I don’t know what’s going on — denial, you know. Women deny.”
Poole knows this because she’s spent years treating women suffering heart attacks at Prisma Health’s Heart and Vascular Institute. Despite the knowledge that women often have difficulty realizing they’re having a heart attack, Poole found herself falling into a similar pattern of thinking she was experiencing anything but a heart attack.
What makes her story even more poignant is that she suffered a specific type of heart attack called Spontaneous Coronary Artery Dissection (SCAD), which is the leading cause of heart attacks in women under 50, pregnant women and new mothers.
Poole is part of a team at Prisma’s Heart and Vascular Health Institute that has become adept at diagnosing and treating SCAD cases and was working with one of its leading physicians, Tara Holder, an interventional cardiologist.
“Carol was working with me on a heart attack,” Holder said. “Talk about the poster child for denial. Why would you have a heart attack doing a (procedure for a) heart attack?”
Holder explained Poole experienced a feature common to SCAD patients: pain in other parts of the body besides the chest. For Poole, the pain seemed centered in her neck.
Holder explained that just as she’s had SCAD patients as young as their early 20s and as old as 81, the types of pain those patients experience can be highly variable.
Related: Technology saved his life. A $400K gift to Prisma gives others the same chance.
‘Listen to your body’
Poole said her experience confirms something she’s heard from countless women patients over the years who said they didn’t know what was going on but felt something in their bodies was not right.
“The biggest thing with women — and I’ve heard a lot of women — (say) ‘I don’t know that anything’s wrong, but something’s just not right.’
“Listen to your body,” Poole said.
Holder said this is particularly true with women regarding heart health in general and SCAD in particular. Research on the phenomenon is still in its early stages and in many ways is being driven by women cardiologists like Holder.
“We’re learning a lot about [SCAD],” Holder said. “There’s a lot of awareness, thankfully, about it in this group … (but) there’s so many questions unanswered in this space, which is a little frustrating but exciting.”
Two resources helping to advance knowledge and awareness of SCAD are the SCAD Alliance and the International Spontaneous Coronary Artery Dissection Registry. Holder said the iSCAD registry is specifically designed to help drive research so new and better protocols and standards of care can be developed
The expertise at identifying and treating SCAD at Prisma’s Heart and Vascular Institute is being driven in part by the frequency with which they see SCAD patients, which is often as many as three or more a month.
Holder said SCAD has been considered a rare type of heart attack but her and her team’s experience shows this is not the case.
For Poole, her team’s experience and expertise meant she was treated quickly and ended up only being out of work for six weeks.
“Listen to your body and don’t delay because time is muscle,” Poole said.
She added that delaying treatment after the onset of symptoms or that feeling of something not being right can lead to worse outcomes.
“It’s so much better to come in and not need to be seen than to come in late and not do as well,” she said.
She said she was also extraordinarily fortunate her heart attack happened while she was surrounded by a team who had the exact set of skills to diagnose and treat her SCAD as it was happening.
“I feel so blessed,” she said.
What is SCAD?
Spontaneous Coronary Artery Dissection is a type of heart attack that occurs when a tear develops in a heart blood vessel wall and is the leading cause of heart attacks in women under 50, pregnant women and new mothers.
Good to know
According to the American Heart Association, cardiovascular disease is the leading cause of death in women and accounts for 1 in 3 deaths each year.
