Spontaneous Coronary Artery Dissection, also called SCAD, is a critical medical condition that develops when a tear is formed in a blood vessel in the heart. This heart problem can slow or impede the blood flow to the heart resulting in a heart attack, heart rhythm issues (arrhythmias) or sudden death.
SCAD most commonly affects women in the age groups 40-50s, however, it can develop at any age and develop in men. People with SCAD often don’t have other risk factors for cardiovascular disease like high blood pressure, high cholesterol, or uncontrolled diabetes. It can cause sudden death if not diagnosed and treated on time. Seek immediate medical care, if you observe heart attack symptoms even if you think you are not at risk of cardiovascular disease.
Symptoms Of SCAD Can Include:
Some of the common symptoms observed include:
- Chest pain
- A rapid heartbeat
- Pain in the arms, shoulders, back or jaw
- Shortness of breath
- Sweating
- Extreme tiredness
- Nausea
- Dizziness
Also Read: Heart Rhythm Disorders: Causes, Symptoms And Treatment
Causes
The exact cause of spontaneous coronary artery dissection is still not clear.
Risk Factors
Common risk factors of SCAD include:
Sex: Though SCAD can develop in both men and women, it tends to affect women more than men.
Fibromuscular Dysplasia (FMD): This health problem causes irregular growth of cells in the artery walls, which can weaken artery walls, resulting in blockages, dissection or aneurysms. Further, it can also cause high blood pressure, stroke, and tears in the blood vessels.
Hormone Therapy: Hormone therapy like oral contraceptives or infertility treatments has been highly linked to SCAD risk.
Medical Conditions: Other medical conditions affecting blood vessels and those that cause inflammation of the blood vessels, like lupus and polyarteritis also have been related to SCAD.
Inherited Diseases: A genetic disorder that results in problems with the body’s connective tissue like vascular Ehlers-Danlos syndrome and Marfan syndrome has been found to develop SCAD.
Uncontrolled Blood Pressure: Severe blood pressure can increase the risk of SCAD.
Drug Use: The use of illegal drugs or cocaine can increase the risk.
Complications
SCAD is a tear inside an artery that carries blood to the heart, when the inner layers of the artery isolate from the outer layers, blood can easily flood in between the layers. The pressure of the flooding blood can make short tear longer and blood also gets trapped between the layers forming a blood clot.
SCAD can also slow the blood flow via the artery, which weakens the heart muscle or can stop the blood flow causing the heart muscle to die (heart attack).
A heart attack caused by SCAD is entirely different from a heart attack caused by atherosclerosis. Even after successful treatment, SCAD can relapse either soon after the first attack or years later. People who suffer from SCAD also have a higher risk of other heart issues like heart failure due to the damage caused to the heart muscle by heart attacks.
Also Read: Heart Failure: Symptoms, Causes, Types And Treatment
Diagnosis
The healthcare provider may recommend certain tests and imaging scans to diagnose SCAD, that are similar to those used to assess other types of heart attacks, which include:
- Coronary angiogram
- Intravascular ultrasound
- Optical coherence tomography
- Cardiac computerized tomography
Treatment
The primary goal of treatment is to restore the blood flow to the heart, ease chest pain and avert recurrence. At times, healing will happen naturally, or healthcare providers may opt for surgery to restore blood flow by opening the artery with a balloon or stent. Bypass surgery may also be helpful.
Generally, the treatments depend on the condition including the size and location of the tear in the artery, as well as the signs or symptoms of the patient. In a few cases, doctors may allow the damaged artery to heal on its own.
Doctors also prescribe medications that may help ease the symptoms of SCAD, in such cases it is possible to be treated with medications alone. However, if chest pain or other symptoms continues, then the person may also need other modes of treatment.
Patients after treatment for SCAD will need regular follow-ups with their healthcare provider to evaluate for any changes in their health status. Doctors may suggest cardiac rehabilitation which includes a tailored exercise program, nutritional counselling and emotional support that is designed to help them recuperate from a severe heart condition.
