In most cases, sudden coronary artery dissection (SCAD) may heal in a few weeks to months.
About 10 percent of the people get the second episode of SCAD and rarely some may have multiple episodes. There is a higher risk of getting another episode within the first few months, and this risk declines thereafter. A majority of the patients, however, live a healthy life after the initial episode.
In most patients, medications are enough to restore blood flow to the heart. Some patients, however, may need surgery.
For adequate healing, it is important to seek urgent medical care and follow the doctor’s advice. Regular follow-up visits are needed with the doctor to assess health. The doctor will guide on when and how to resume daily activities. A person must discuss with them any physical activities, including sports or exercise, that they wish to pursue.
What is SCAD?
Sudden coronary artery dissection or SCAD is a serious heart condition that results when there is a tear or break in the inner lining of a coronary artery, which are the blood vessels supplying the heart.
Coronary arteries carry oxygen and nutrients required for the proper functioning of the heart and contain a three-layered wall.
- When there is a tear in the innermost layer, blood tends to seep in between the layers of the coronary artery.
- The tear may create a tissue flap and promote blood clot formation.
- These factors lead to partial or complete obstruction of blood flow to the heart, leading to a heart attack, abnormal heart rhythm (arrhythmia), and even death.
A typical heart attack involves obstructed blood flow to the heart, but unlike SCAD, the obstruction is caused by the build-up of lipid-rich plaque in the lumen of coronary arteries.
What are the risk factors of SCAD?
Sudden coronary artery dissection (SCAD) can affect any person, regardless of age and gender. It is, however, more common in women in the age group of 40 to 50 years.
SCAD is the leading cause of pregnancy-associated heart attacks and is considered one of the most common causes of heart attacks in women younger than 50 years old. It is about four times more common in women than in men.
SCAD can affect people who are healthy and have no recognizable risk factors for a heart attack.
The major risk factors of SCAD are:
- Female gender
- Recent childbirth
- Age 40 to 50 years
- Intense exercises or physical activity
- Blood vessel diseases, such as fibromuscular dysplasia (a condition in which there is abnormal cell growth in the arteries, leading to narrowing, bulging, or tearing of the arterial wall)
- Extreme emotional stress
- Genetic factors
- Perimenopausal period
- Uncontrolled high blood pressure
- Cocaine abuse
What are the symptoms of SCAD?
The symptoms of sudden coronary artery dissection (SCAD) occur due to a decrease in blood supply to the heart and include:
- Chest pain, tightness, or heaviness
- Shortness of breath
- Rapid heartbeat or palpitations
- Easy fatigability
- Pain in the shoulder, arm, or jaw
- Feeling sick or unwell
SCAD is an emergency condition. If any of these symptoms are experienced, emergency medical attention must be sought.
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Heart Foundation. Spontaneous coronary artery dissection (SCAD). https://www.heartfoundation.org.nz/your-heart/heart-conditions/spontaneous-coronary-artery-dissection
Cleveland Clinic. Spontaneous Coronary Artery Dissection (SCAD). https://my.clevelandclinic.org/health/diseases/17503-spontaneous-coronary-artery-dissection-scad
Iorfino M. SCAD: What’s Overlooked Can Be Fatal. Penn Medicine. https://www.pennmedicine.org/news/news-blog/2019/february/scad-whats-overlooked-can-fatal
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