What is Spontaneous Coronary Artery Dissection?(Spontaneous Coronary Artery Dissection or SCAD)

Spontaneous Coronary Artery Dissection, or SCAD, is a rare, non-atherosclerotic cardiac emergency that causes a myocardial infarction when the wall of a coronary artery suddenly tears.

SCAD primarily affects women under 60 years of age without cardiovascular risk factors.

The most common symptoms are:

Pain in the center of the chest
Pain or numbness in one or both arms
Jaw pain
Back pain
Shoulder pain
Nausea
Sweating/cold and clammy skin
Shortness of breath

Chest pain in young, healthy people with no history or risk factors for heart disease is often attributed to anxiety, panic attacks, indigestion, gallstones, or other conditions.

It is crucial not to delay the diagnosis of SCAD. The sooner it is diagnosed, the better the prognosis. The longer blood flow is reduced, the greater the likelihood of permanent damage to the heart muscle.

Diagnostic tests for SCAD

Electrocardiogram (ECG): Records electrical activity; results may be normal in some SCAD cases.
Blood biochemistry: Troponins are analyzed; the presence of these proteins in the blood indicates that myocardial injury has occurred.
Echocardiogram: Measures the ejection fraction (EF), which is the percentage of blood volume expelled with each heartbeat.
Selective coronary angiography: Using a catheter, the flow and internal state of the coronary arteries are examined precisely.
Intracoronary imaging with OCT (Optical Coherence Tomography) and IVUS (intravascular ultrasound).

Etiology

The cause of SCAD is unknown.
Some hypotheses indicate that it may be related to stress or female hormones, as its incidence increases after childbirth or during perimenopause.

Treatment

Treatment is personalized and initially conservative, except in high-risk cases.
Hospital monitoring for at least 3 to 5 days.
Beta-blockers (BB) are antiarrhythmics that could reduce recurrence. Thrombolytics and anticoagulants should be avoided.
Antiplatelet agents (ASA 80-100mg/day) are usually indicated during the first year.
Cardiac rehabilitation and control of classic cardiovascular risk factors.
Screening for Fibromuscular Dysplasia: Angio-CT from head to pelvis.

Signs to be alert for

Chest pain

It is the main sign of SCAD. It feels like strong pressure or a weight in the chest. Although the pain can also be located in the jaw, shoulders, or back.

Extreme fatigue

Feeling exhausted or out of breath after small efforts, such as walking a little.

Starting a new life after an FMD or SCAD diagnosis is a challenge, but you are not alone; with patience and support, you will succeed.
It is a new stage where the most important thing is to learn to take care of yourself calmly. We give you some tips so you can feel safe.

Listen to your body:
- If you feel tired, stop. Do not force yourself to exert more effort.

Exercise:
- Physical exercise is important; keep moving.
- Ask your doctor what physical exercises you can do without damaging your arteries.

Your mind matters:
- It is normal to feel afraid.
- Sharing how you feel will take a great weight off your shoulders.

Living with the disease

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