Spontaneous coronary artery dissection (SCAD)


Spontaneous Coronary Artery Dissection (SCAD) is a rare condition in which one or more of the coronary arteries, which supply blood to the heart muscle, suddenly tear or dissect without any obvious external cause such as trauma or atherosclerosis. This condition can lead to reduced blood flow to the heart muscle and cause a heart attack or other cardiac complications.

Causes of SCAD: The exact cause of SCAD is not always clear, but it is believed to be related to the following factors:

  1. Connective Tissue Disorders: Some individuals with connective tissue disorders, such as Ehlers-Danlos syndrome or Marfan syndrome, may be at a higher risk for SCAD.

  2. Hormonal Factors: Hormonal changes, particularly those associated with pregnancy and childbirth, have been linked to SCAD. Many cases occur in young and otherwise healthy women.

  3. Arterial Wall Abnormalities: Structural abnormalities in the coronary artery walls may make them more susceptible to dissection.

  4. Physical Stress: Intense physical exercise or extreme emotional stress may trigger SCAD in some cases.

Symptoms of SCAD: The symptoms of SCAD can be similar to those of a heart attack and may include:

  • Chest pain or discomfort

  • Shortness of breath

  • Nausea

  • Sweating

  • Fatigue

  • Pain radiating to the arm, jaw, neck, or back

It's essential to seek immediate medical attention if you experience these symptoms, as SCAD can be life-threatening.

Treatment of SCAD: The treatment of SCAD can vary depending on the severity of the condition and the specific circumstances of the patient. Treatment options may include:

  1. Medical Management: In less severe cases, medical management may be sufficient. This can include medications to alleviate symptoms, reduce blood pressure, and prevent blood clot formation.

  2. Angioplasty and Stenting: In some cases, the dissection can be treated with angioplasty and stenting. A thin tube (catheter) is inserted into the artery to open the blockage, and a stent is placed to help keep the artery open.

  3. Coronary Artery Bypass Grafting (CABG): In more severe cases, coronary artery bypass surgery may be necessary to reroute blood flow around the damaged artery.

  4. Conservative Management: In selected cases, particularly when the dissection is not causing significant blockage or symptoms, a conservative approach may be taken, and the patient may be closely monitored without intervention.

It's crucial to work closely with a healthcare team experienced in managing SCAD, as the appropriate treatment strategy can vary widely depending on individual circumstances. Lifestyle changes, such as reducing stress and avoiding high-intensity exercise, may also be recommended to reduce the risk of recurrent SCAD episodes. Long-term follow-up care and cardiac rehabilitation are often part of the recovery process for individuals with SCAD.