Spontaneous Coronary Artery Dissection (SCAD)

Overview

Spontaneous coronary artery dissection (SCAD) is a critical medical emergency where a tear develops in the wall of a coronary artery. Often referred to simply as SCAD, this condition can significantly hinder or completely obstruct blood flow to the heart, leading to a heart attack, arrhythmias, or even sudden death.

Although SCAD is most prevalent among women aged 40 to 50, it can affect individuals of any age and gender. Remarkably, those affected by SCAD frequently lack traditional heart disease risk factors such as hypertension, high cholesterol, or diabetes.

Due to its potentially fatal consequences, immediate medical intervention is crucial for anyone experiencing symptoms of a heart attack, regardless of their perceived risk level for heart issues.

Symptoms

Symptoms of SCAD may include:

• Dizziness
• Difficulty breathing.
• Excessive sweating.
• Severe fatigue.
• Nausea or stomach upset.
• Rapid or irregular heartbeat.
• Feeling of pressure or pain in the chest.
• Pain extending to the arms, shoulders, back, or jaw.

In cases of chest pain or symptoms suggestive of a heart attack, it is crucial to contact emergency services immediately or your local emergency number. If emergency medical services are unavailable, have someone else drive you to the nearest hospital. Avoid driving yourself unless absolutely necessary.

Causes

The exact cause of spontaneous coronary artery dissection (SCAD) remains unclear.

Risk factors

Factors that may increase the risk of SCAD include:

• Gender: Being female. While SCAD can affect anyone, it predominantly impacts women.
• Childbirth: Some women who have experienced SCAD have recently given birth. This may be attributed to hormonal changes and stress on the blood vessels. SCAD often occurs within the first few weeks after delivery but can also manifest during pregnancy.
• Extreme stress: SCAD may occur following periods of intense stress, including strenuous physical activity and severe emotional distress.
• Fibromuscular dysplasia (FMD): This condition weakens the body’s medium-sized arteries, potentially leading to artery problems such as aneurysm or dissection. FMD is more prevalent in women than in men.
• Genetic connective tissue disorders: Ehlers-Danlos and Marfan syndromes have been associated with individuals who have experienced SCAD.
• High blood pressure: Extremely high blood pressure can elevate the risk of SCAD.
• Illegal drug use: The use of substances like cocaine or other illegal drugs may heighten the risk of SCAD.