Overview of Spontaneous Coronary Artery Dissection (SCAD)

What Is Spontaneous Coronary Artery Dissection?

What is it?

Spontaneous Coronary Artery Dissection (also known as SCAD), is a heart disease which is becoming more common than previously thought. When you have an incidence of SCAD, the coronary arteries which supply blood to your heart can develop a tear in their inner layer.

When the tear in your artery occurs, blood can seep into the different layers of your arteries, resulting in a potential blockage, which can slow down and block the flow of blood to your heart.

This tear can be problematic as it may result in heart conditions including rhythm issues, chest pain/angina, heart attack as well as death.

Women unfortunately are at most risk of SCAD, with sufferers typically aged in their 40s-50s, however women as well as men of any age can suffer from SCAD. Furthermore, those affected by SCAD typically do not have standard risk factors for Heart Diseases.

SCAD as a condition is still often misdiagnosed and treated as an instance of Heart Attack, however understanding and management of SCAD has rapidly improved in recent years.

SCAD Causes

Causes

The causes of SCAD are still not as clearly known as other Heart Diseases; however, there are some conditions or factors which have been linked to incidence of SCAD.

These factors include:

  • Conditions affecting blood vessels, including a condition called Fibromuscular Dysplasia
  • Female gender
  • Pregnancy and birth
  • Use of recreational drugs
  • Major emotional stress
  • Major exercise
  • Inflammatory medical conditions such as Rheumatoid Arthritis and Lupus
  • Hormonal therapies
  • Disorders affecting connective tissue including Marfan Syndrome

Statistics

Due to SCAD being a fairly new area of research, it is difficult to report on the burden of SCAD for the population.

The Victor Chang Institute suggests that around SCAD is the cause of 24% of cases for Heart Attack in women aged less than 50, as well as accounting for 2-4% of the overall presentation of Acute Coronary Syndrome (where these is a sudden loss of blood flow to the heart).

Research also suggests that it the main cause of Heart Attack in pregnant women, occurring in 43% of cases.

Spontaneous Coronary Artery Dissection Statistics

Symptoms

Signs and Symptoms

The signs and symptoms of SCAD can be similar to those of a heart attack, all of which require urgent medical attention:

  • Chest pain
  • Arm, jaw or shoulder pain
  • Shortness of breath
  • Sweating
  • Rapid heartbeat/feelings of a fluttery chest
  • Extreme fatigue
  • Nausea
  • Dizziness
SCAD Symptoms

Treatment for SCAD

The treatment for SCAD will depend on your condition, typically depending on factors such as the tear location on your arteries, as well as on the size of the tear.

Typically, medication is the preferred course of treatment. If your SCAD does not heal naturally, treatment options for include:

Stenting:

if the blood flow in your coronary artery is blocked or you continue to suffer chest pain even when taking medications, you may need a stent (a tiny tube made of mesh) placed inside your coronary artery to help it open and restore blood flow. See coronary angiogram and stenting.

Bypass surgery:

depending on your SCAD condition, your doctor may recommend bypass surgery if you have more than one tear in your arteries, or if other treatments have not yet worked. See Coronary Artery Bypass Graft Surgery.

Medications:

there are medications which your doctor may recommend you take. These medications include: medications such as blood-thinners to prevent any clots forming in your torn coronary artery, Aspirin as a prevention for other cardiac issues, cholesterol medications if you have a higher cholesterol reading, blood pressure medications to reduce the pressure on your torn artery as well as medications to manage chest pain. NPS Medicinewise is a free, useful and evidence-based website to find out more about different medications.

Follow-up treatment:

cardiac rehabilitation, reviewing any family medical history to assess if there are any genetic predispositions for SCAD, as well as scans to look at other arteries to prevent new SCADs developing.

Prevention and Support

Follow the links below to find out more about how you can help prevent and support loved ones who have experienced SCAD

Prevention

Prevention

Whilst there are no specific prevention strategies for SCAD, it is recommended that you try to have a healthy heart by following the simple steps for heart disease prevention
Supporters

Supporters

A support group is a good way to meet other people who have SCAD. Talking to other people who are in a similar boat to you can help you get through a tough time
Carers

Carers

Caring for someone with SCAD can be difficult. If you are struggling to care for a loved one, reach out and discuss how you feel with someone today. Your health is important too

FAQs

What you need to know

Typically, younger women around the ages of 45-52 are more affected by SCAD, with these women typically not displaying other traditional Heart Disease risk factors such as smoking and being overweight.

Anyone affected by SCAD, including women, are more likely to have a recurring instance of SCAD and may have ongoing heart conditions.

Long-term implications for SCAD depend on the severity of your SCAD event. As mentioned earlier, you may need more invasive treatments such as stenting or take medications.

Your doctor will be able to discuss with you what the long-term implications are for your recovery, your life and your loved ones.

If you are diagnosed with SCAD, we recommend speaking with your doctor and treating team to learn more about daily management.

Research suggests that attending a Secondary Prevention Program for managing Heart Diseases can decrease the chance of being admitted to hospital, reduce your complications as well increase survival rates.

One suggestion is cardiac rehabilitation, as these programs will teach you more about your disease, help you recover, empower you to make lifestyle changes to improve heart health as well as reduce your risk of further problems. Click here to find your nearest cardiac rehabilitation program.

Your doctor may have recommended that you take some new medications if you have SCAD.

This could be an overwhelming time for you, especially as learn all about your new medications as well as any considerations for taking them. Apart from having a discussion with your doctor and pharmacist, NPS Medicinewise has some great information on medication management, medication disposal as well as risk factors.

They also have some great information about medications for your heart, which can be found here.

It’s not too late to start looking after your heart health, even after an event of SCAD.

Here are some great and easy everyday strategies you can do to look after your heart health:

  • Don’t smoke, as quitting smoking can reduce your risk by 50% in one year. Quitline would be a great way to start your quitting smoking journey.
  • Stay active, 30 minutes per day of exercise, such as walking, can reduce your risk by 30% and delivers many positive health benefits. More information about exercise as well as a sample walking session can be found here.
  • Get some sleep, aim for 7-8 hours sleep and aim to try and unplug from your technology (e.g. iPad) one hour before bedtime. The Sleep Health Foundation has many great women’s focused sleep pages for all stages of your life such as your menstrual cycle, pregnancy, new mothers and menopause.
  • Eat healthy: ensure you watch portion sizes, eat healthy and nourishing foods such as: high fibre foods (including oats and legumes), two pieces of fruit and seven serves of vegetables, reduced salt, three serves of fish per week, reducing saturated fats (such as chicken with skin on, baked goods, fried foods) whilst choosing more lean proteins such as tofu and trimmed meats. The Baker Heart and Diabetes Institute has created some handy factsheets to help you choose correct portions, supermarket shopping, healthy snacks and eating out.
  • Relax: try and take some time out for yourself, keep connected with friends and family, perhaps try activities such as meditation to help manage your stress levels. Beyond Blue has a great page full of practical stress relieving tips, and it could be worth to try some meditations from apps such as Smiling Mind, Headspace and Calm.

Yes! There are support groups and associations you can contact to connect with other women who have survived SCAD, or with those who have lost loved ones due to the condition.

Australian SCAD Survivors is a Facebook support group for people who have survived SCAD.

https://www.facebook.com/groups/AustralianSCADsurvivors/?fref=ts

The Victor Chang Cardiac Research Institute is running the first Australian SCAD survivors research group, as well as providing research updates on SCAD.

https://www.victorchang.edu.au/scad

SCAD Research Australia is a not-for-profit organisation which provides desperately needed funds for research into SCAD:

https://scadresearchcomau.wordpress.com/

Spontaneous Coronary Artery Dissection FAQs