Spontaneous Coronary Artery Dissection, or SCAD, is a tear in the wall of aheart artery with internal bleedingthat can result in a blockage of blood flow to the heart muscle causing a heart attack.
It is estimated that about 0.1 to four percent of all heart attacks are caused by SCAD. Although rare, this condition accounts for an estimated 25 percent of heart attacks in women under age 50
SCAD, in fact, occurs almost exclusively in women. An estimated 85-90 percent of cases are typically women between ages 30 and 60.
SCAD is a rare and concerning condition that still has much uncertainty regarding ideal treatment and recommendations.
What Causes Spontaneous Coronary Artery Dissection?
The mechanism of SCAD is not fully understood. There may be some factors that increase risk, such as hormone changes surrounding pregnancy or delivery, hormone therapy, coronary artery tortuosity (twisty instead of straight arteries), extreme physical stress, and genetic conditions such as fibromusculardysplasia and Marfan syndrome.. Most of the time, a cause is not identified.
If you are diagnosed with SCAD it is important to work with your cardiologist to look closely for some of the possible associated conditions.
Spontaneous Coronary Artery Dissection Symptoms
Typically, SCAD presents just like a typical heart attack. If you experience unusual chest pain or think you might be having a heart attack, call 911.
A SCAD episode can include:
- Chest pain, pressure or tightness
- Rapid heartbeat
- Sweating
- Shortness of breath
- Exhaustion
- Pain in the back, jaw, arms or shoulders
- Dizziness
- Fainting
- Nausea, vomiting
Diagnosing Spontaneous Coronary Artery Dissection
A diagnosis will start with a physical exam, a review of your medical history and any of these tests:
Treating Spontaneous Coronary Artery Dissection
Thorough assessment of the severity of the tear and the degree of damage to your artery and heart – will determine your treatment.
Most patients are treated with aspirin or another antiplatelet medication that prevents blood clots. If you have high blood pressure, you doctor might prescribe ACE inhibitors and beta blockers. Rarely, some patients also require a coronary artery stent or surgery.
You doctor will monitor your condition regularly. Even though SCAD is rarely fatal, upto 20 percent of patients experience SCAD again. You will work with your doctor to address any symptoms following your SCAD, the psychological stressors associated with this condition, and any reproductive issues.