SCAD

Causes 

SCAD is a rare heart condition that happens suddenly without apparent warning. At this point in time, it cannot be predicted or prevented. 
The cause of SCAD is unknown.
Further research about SCAD is needed to learn more about this condition and better understand it.  

Who it Affects 

SCAD most commonly affects women in their 40s and 50s. However, it can happen at any age and can occur in men.  

• About 80% of those with SCAD are women  

Most people who have SCAD do not have usual risk factors for cardiovascular disease such as smoking, diabetes, or high cholesterol.  

Risk Factors 

The risk factors for SCAD include:  

• Being female 
  • SCAD can happen to anyone at any age, but it most commonly affects women who are in their 40s and 50s.  
    • Suggests that SCAD is more likely to occur around the time of menstruation or during menopause.  
• Pregnancy and Childbirth 
  • Some women who have had SCAD have recently given birth. SCAD has been found to occur most often in the first few weeks after delivery. 
  • SCAD also can occur during pregnancy. 
  • Why?  
    • This may be due to changes in hormones and stress on the blood vessels.   
• Extreme stress 
  • SCAD can happen after extreme stress, including intense physical exercise and severe emotional distress. 
• Fibromuscular dysplasia (FMD) 
  • FMD = A condition that causes weakening of the body’s medium-sized arteries.  
  • FMD may lead to artery problems such as aneurysm or dissection.  
  • Women are more likely to have FMD than men. 
• Genetic conditions affecting connective tissue 
  • Ehlers-Danlos and Marfan syndromes have been found to occur in people who have had SCAD. 
• High blood pressure 
  • High blood pressure can increase the risk of SCAD. 
• Illegal drug use 
  • Using cocaine or other illegal drugs (amphetamines or methamphetamines) might increase the risk of SCAD. 

Symptoms 

Symptoms that an individual may experience when they have SCAD include:  

• Chest pain or pressure 
• Pain in the arms, shoulders, back or jaw 
• Unusual sweating or clamminess  
• Nausea and vomiting or indigestion  
• Feeling dizzy 
• Shortness of breath 
• Extreme tiredness 
• Rapid heartbeat or fluttery feeling in the chest  

If you are experiencing chest pain or any of the symptoms listed above, call 999 immediately.  

• It is important to get checked out if you get any SCAD symptoms, so it can be diagnosed as early as possible.  

Diagnosis  

SCAD is diagnosed after it occurs (post event).  

Because the symptoms of SCAD are similar to a heart attack, it is usually diagnosed through the following examinations:  

• Blood tests 
  • Typically blood tests for troponin are done.   
    • Troponin = A protein released into the blood when heart blood vessels are damaged.  
• Electrocardiogram (ECG) 
  • An ECG shows the electrical activity in the heart and highlights any changes in heartbeat.  
• CT Angiogram  
  • A coronary CT angiogram uses X-rays of the heart to make detailed images of the heart and the heart’s arteries.  
  • This involves injection of a special dye to make arteries clearer in the image.  
    • The dye injection exposes an individual to small amounts of radiation. Some conditions may mean that an MRA should be done instead.  
• Echocardiogram  
  • An echocardiogram uses an ultrasound to look at the heart beating. 
• Magnetic resonance angiogram (MRA) 
  • An MRA Uses an MRI machine to take images of the heart.  
  • It cannot be done if an individual has certain magnetic materials in their body (e.g. pacemaker, cochlear implant, vagal nerve stimulator).  

Treatment  

The treatment for SCAD varies for everyone and depends on their condition and how severe their symptoms are.  

Examples of management and treatment for SCAD include:   

• Medication to prevent blood clots and lower blood pressure may be prescribed if need.  
  • Examples of medications include blood thinners, aspirin, or beta blockers. 
• If SCAD had blocked the blood flow to the heart muscle, then an insertion of a stent in the affected artery may be recommended.  
• A coronary artery bypass surgery may be conducted to restore blood flow to the heart.  
  • This is a rare treatment method for SCAD.  
• Cardiac rehabilitation may help recover and return to living life as fully as possible. 
  • Cardiac rehab = Mix of exercising in a safe, monitored space, education, relaxation, and psychological support.