SCAD

1 What is Spontaneous Coronary Artery Dissection (SCAD)?

Spontaneous coronary artery dissection (SCAD) is a rare emergency condition in which one of the blood vessels in the heart tears off. This condition can slow down or completely block blood flow to the heart leading to heart attacks, abnormal rhythm which in turn leads to acute heart failure

SCAD tends to affect people between the age of 30-50. This condition can be a cause of sudden death if it is not diagnosed and treated promptly.

2 Symptoms

Signs and symptoms of spontaneous coronary artery dissection (SCAD) include:

  • chest pain irradiating to the arms, shoulders or jaws,
  • fluttery feeling in the chest,
  • sweating,
  • tiredness and dizziness.
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3 Causes

The cause of spontaneous coronary artery dissection (SCAD) is not clear. This condition occurs due to the superficial tear in the coronary artery. Blood accumulates between the layers of the artery wall and the pressure makes a short tear much longer.

This condition gradually slows down the blood flow to the heart which leads to heart attack

4 Making a Diagnosis

Spontaneous coronary artery dissection (SCAD) cannot be diagnosed with simple physical examination. Certain special tests are required like coronary angiogram this test involves creating pictures of the arteries and looking for abnormalities. 

Cardiac catheterization and coronary angiogram during this procedure doctors inject a special dye into the arteries through a tin tube catheter so they will show up in the imaging tests. Once the dye is released x ray pictures are created which will confirm SCAD.  

After coronary angiogram some additional tests may be used which include intravascular ultrasound (in this test special catheter is introduced into the arteries which create sound wake pictures. Optical coherence tomography catheter containing a special light is inserted into the arteries to create light based pictures. 

A cardiac CT angiography scan, which collects images of the heart and vessels from various angles and helps to eliminate all other causes.

5 Treatment

The main aim of the treatment for spontaneous coronary artery dissection (SCAD) is to repair the tear of the artery and restore blood flow to the heart. And the treatments vary according to situation, size of the tear, and location of the tear. 

The following procedures are recommended: 

  • Medications. Drugs which reduce the number of blood clotting platelets (anti-coagulants) and drugs that are used to treat high blood pressure may reduce the risk of SCAD. In some situations, these medications relieve all symptoms and makes it possible for further surgery. But if symptoms persist other treatments are required. 
  • Placing a stent to open the artery. If SCAD has blocked blood flow completely to the heart and medications are not able to relieve chest pain, then the doctors may recommend placing a stent ( tiny mesh tube inside the artery to hold it open). It is usually guided by x-ray or other imaging tests. 
  • Surgery to bypass the damaged artery if any of the above treatments did not work then it is recommended to create new path for the blood to reach the heart. This involves removing a blood vessel from another part of the body and stitching it to the place of damage and will divert the blood flow around the damaged artery. 

Continuous care since this condition re-occurs frequently the doctor would recommend the following types of post-surgical care:

  • Undergoing cardiac rehabilitation: This program is directed to spread awareness about different heart conditions and it includes monitored exercises nutrition and emotional support. 
  • Reviewing family history: some diseases like marfan syndrome are found to be associated with SCAD therefore proper review of such inherited diseases in the family should be done. Looking for weaknesses in our blood vessels. 
  • Most often doctors may suggest CT scanning in order to find weaknesses in other parts of the body.

6 Prevention

The prevention of spontaneous coronary artery dissection (SCAD) includes the following steps:

  • avoid usage of alcohol and cocaine,
  • avoid smoking,
  • leading a healthy life,
  • avoiding extreme physical excretion,
  • maintaining proper blood pressure.

7 Alternative and Homeopathic Remedies

Being an emergency situation there are no alternatives home remedies to treat spontaneous coronary artery dissection (SCAD).

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with spontaneous coronary artery dissection (SCAD).

The diagnosis of spontaneous coronary artery dissection (SCAD) comes across as a scary and a shocking diagnosis.

So it is important to find certain ways to cope with the situation. These ways include:

  • learning about SCAD (spontaneous coronary artery dissection).
  • connect with others living with same condition.
  • taking good care of oneself.

9 Risks and Complications

There are several risks and complications associated with spontaneous coronary artery dissection (SCAD).

The following risk factors are found to play a major role in development of this disease:

  • female sex,
  • giving birth,
  • irregular growth of cells in the artery wall (a condition called fibromuscular dysplasia) which can lead to weakening of the artery walls,
  • extreme physical excursion,
  • blood vessel problems,
  • disease of diffuse connective tissue,
  • very high blood pressure,
  • smoking and alcoholism. 

Complications

This disease tends to relapse despite of successful treatment the cause is unknown and under study.

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