A rare and poorly understood heart affliction has been identified as the cause of a Yellowstone National Park spokeswoman’s death in May.
Amy Black Bartlett, 41, died at Bozeman Health Deaconess Hospital on May 15 after being rushed by ambulance from her Corwin Springs-area home, just north of Yellowstone.
An autopsy conducted by the state medical examiner in Missoula identified spontaneous coronary artery dissection, known by the acronym SCAD, as the cause of Bartlett’s death, according to Bonnie Whitman, deputy coroner for Gallatin County.
“Four or five years ago, it was thought to be incredibly rare,” said Sharonne N. Hays, a cardiologist and the principal investigator for the Mayo Clinic’s SCAD Research Program in Rochester, Minn. “We all thought it was so uncommon, but a lot of it was missed.”
First described in 1931, recent research such as that conducted by Hays and others has shown the condition to be much more common than was previously thought. Hays said SCAD is now recognized as “probably the No. 1 cause of heart attack” in otherwise healthy younger pregnant women or women who have just given birth.
Bartlett had given birth to her third child, a girl named Ella Faith Kathleen Bartlett, only eight days before her heart attack.
Heart of the matter
It’s only been in the last 15 years that the medical community has become more aware of heart disease in women, Hays said. Until the launch of the Go Red for Women program, started by the American Heart Association in 2004, she said “women were literally be ignored and told it was in their head” when they complained of classic heart attack symptoms like chest pressure, a cold sweat and arm pain. Now it’s known that cardiovascular diseases such as heart attack and stroke are the cause of death for about one out of every three women in the United States, according to the AHA.
Within the scope of heart disease, though, spontaneous coronary artery dissection is a “rare emergency condition that occurs when a tear forms in one of the blood vessels in the heart,” according to the Mayo Clinic’s website. Since women who are pregnant or have recently given birth typically don’t feel well anyway, it’s easy for the mothers to dismiss or ignore the symptoms of a heart attack, Hays said.
Although the cause of SCAD is unknown, researchers believe a combination of factors may lead to the condition, including: “blood vessel changes, sex hormone changes, blood volume changes and other changes in women related to pregnancy or menopause,” according to the SCAD Research website. “In both men and women, extreme exertion and extreme stress appear to play a role.”
“What we’ve also found is that most of these people have some underlying blood vessel abnormality,” Hays said. “They may have weak blood vessels to start with.”
Warning signs of the condition include: chest pain or pressure, shortness of breath, profuse sweating and dizziness, according to the AHA.
The Mayo Clinic has created a SCAD Research Team to investigate the condition since “most SCAD patients are healthy young women who do not have conventional risk factors for heart disease” and the cause and treatment of the affliction are poorly understood.
Whitman said Bartlett’s case has been accepted by the Mayo Clinic as part of its SCAD study.
“We hope there will be more information gained through the study,” Whitman said. “There’s a lot to be learned.”
Bartlett’s husband, Jerry, who is also a Yellowstone employee, called 911 and started CPR shortly after Amy collapsed around midnight, Whitman said. A medical helicopter was called off because CPR cannot be performed while flying, she said. Instead, ambulance crews continued resuscitation efforts throughout the 70-mile drive to Bozeman. Bartlett was pronounced dead at 2:54 a.m.
Her obituary stated that Bartlett had long been a fighter. She was born to Kathleen and Douglas Black on Jan. 26, 1975, three months premature and weighing only 3 pounds, 4 ounces.
More than $29,800 has been pledged by almost 400 donors to a website-based fund set up for the Bartlett children. Another fund established at Gardiner’s First Interstate Bank collected “many deposits from people around the U.S.,” according to a bank spokesperson, who would not divulge the amount.
On the gofundme website, Jerry Bartlett expressed his thanks to all who had donated to the fund.
“This would be a very challenging endeavor with just my boys, but having a 2 week old daughter changes everything and this fund will be used to take care of her and help give me some time to get used to being a single parent,” he wrote.
Editor's note: The headline was changed and updated at 8:45 a.m., July 5, 2016.