Spontaneous Coronary Artery Dissection (SCAD) - Not an Ordinary Heart Attack

SCAD

Spontaneous coronary artery dissection, also known as SCAD, is a rare heart disease that is highly misdiagnosed and often leads to sudden death.

Many people regard SCAD as a typical heart attack, which is a wrong assumption. SCAD is an uncommon condition that occurs instantly without prior warning.

According to one 56 years old veteran heart nurse at Rochester Mayo Clinic, Kristin O' Meara, who battled SCAD at one time, she didn't think much of a heart problem after experiencing sharp chest pain. She started contemplating whether it was "a gallbladder attack or an esophageal spasm."

Along with other progressing symptoms, she concluded that it must have been "a typical heart attack."

Even though she was a veteran heart nurse with a work experience of 30 years, her diagnosis was wrong. Fortunately enough, she found herself in the right hands after her husband drove her to the hospital.

The ER Doctors and nurses that attended to her after arrival in the hospital, instantly recognized what was presumed to be a classic heart attack. They correctly diagnosed it to be a spontaneous coronary artery dissection and promptly proceeded with the right treatment.

That was three years ago.

Today, many SCAD patients would confess to having missed the clear tell-tale signs or symptoms, probably through a lack of information or through denial. Some medical staff would also mistakenly misdiagnose this cardiac condition. Such dire mistakes often lead to wrong treatment that may contribute to SCAD fatality.

Through this article, walk with us to get the right information and awareness concerning this rare artery condition, spontaneous coronary artery dissection. You can then be able to identify the signs if it occurs to you or your loved one.

What is Spontaneous Coronary Artery Dissection (SCAD)?

Spontaneous coronary artery dissection is a rare heart disease that occurs when a tear occurs unexpectedly in one of the three layers of a coronary artery wall. Some of the blood flowing into the artery would then miss the right channel to enter into the space left by the torn artery wall layer.

The coronary artery wall fills with blood to then bulge inward and narrow the artery to restrict blood flow. Sometimes the compression can completely block the artery and subsequently lead to a heart attack.

Spontaneous Coronary Artery Dissection (SCAD) Overview

SCAD is a different condition from the commonly known cause of heart attack, which is atherosclerosis.

Atherosclerosis occurs due to plaque building inside the coronary artery from the collection of cholesterol, fat, calcium, and other waste material in the artery wall. On the other side, SCAD happens suddenly and without prior warning by an instant tear of the coronary artery wall layer.

The dissected tissue allows blood to flow in between the artery wall layers to quickly fill and constrain the artery inwards to narrow or block. The affected artery may slow the blood flow or even prevent blood from flowing towards the heart muscle.

Two coronary arteries supply blood to the heart muscles, the left coronary artery, and the right coronary artery. The two arteries branch off from the aorta, the main artery that takes blood into the heart. (Know more about your blood circulation by reading our article on Circulatory System).

Besides heart attack, SCAD can also lead to a life-threatening arrhythmia or irregular heartbeat rhythm and, subsequently, sudden cardiac arrest.

If the health condition is misdiagnosed or fails to get emergency medical attention, it can lead to sudden cardiac arrest and instant death.

SCAD is a peculiar disease that may fail to forewarn through signs of its onset. In most cases, severe chest pain may be the first sign of SCAD. By the time you experience other symptoms, you are almost and most likely to experience a heart attack.

Both males and females who are known to have SCAD have no heart attack history or risk factors such as diabetes, cholesterol, or high blood pressure. They are bouncing-active and healthy people that are least susceptible to heart disease.

SCAD predominantly affects women than men and at the age bracket of 40 and 50 years. Women take the most significant share of the SCAD population to claim an estimated figure of 90% cases. Even though SCAD is less-known heart disease, it is responsible for more than 35% of women with heart attacks under 50 years old.

What Causes Spontaneous Coronary Artery Dissection?

Spontaneous Coronary Artery Dissection remains a puzzling condition that little is known of its causing factor. But, one thing we are sure about SCAD is that it occurs due to the tearing of one among the three layers of the coronary artery wall. What causes such damage is still a mystery researchers are yet to solve.

Spontaneous Coronary Artery Dissection Risk Factors

Despite research still going on to discover the cause of SCAD, it is essential to know what can put you at risk of this heart disease. Nevertheless, not everyone who gets tested for SCAD falls under the list of risk factors. The condition can occur to anyone and at any time.

The following are some of SCAD risk factors:

  • Age - At the age between 40 and 50 years, you are at a risk factor of experiencing SCAD
  • Gender - Even though any gender is at risk of SCAD, women are more at risk than men.
  • Health conditions - one underlying blood vessel condition, fibromuscular dysplasia (FMD), relates closely with SCAD. The disease weakens the artery walls by creating abnormal cell growth of the artery walls. Besides SCAD, FMD can also lead to blood pressure, aneurysms, or stroke.
  • The systemic lupus erythematosus (SLE) also relates to SCAD. The first SLE presentation or symptom is SCAD making it another health condition risk factor.
  • Hormonal changes - Any reason for hormonal changes can contribute to the SCAD risk factor. Menopause, recently giving birth, nearing entering or during the menstrual cycle, are some hormonal changes risk factors.
  • Genetic conditions - Chromosome 6 is a genetic risk factor associated with fibromuscular dysplasia (FMD). As we mentioned earlier, FMD closely links with SCAD. Other genetic conditions related to SCAD are Marfan syndrome. SCAD is also a directly inherited disorder through genetic mutations.
  • Severe high blood pressure - An extremely high blood pressure can lead to SCAD.
  • Atherosclerosis - Besides coronary artery diseases, atherosclerosis is also a risk factor for SCAD.
  • In one 1998 SCAD study carried out on 42 cases, of the 35, the reason for the condition was atherosclerotic plaque rupture. The study then remarks that "atherosclerosis is one of the main risk factors for spontaneous CAD."
  • Intense exercise - SCAD is also associated with heavy lifting or intense workouts, especially among young people. You are at even a high risk of SCAD if you are in the above risk factors, and you exercise intensely.
  • Severe emotional stress - High emotional stress such as the death of a loved one, loss of livelihood, broken relationships can trigger SCAD. It would, therefore, be an advantage to your heart health if you manage your stress.
  • Using illegal drugs - Using illicit drugs such as cocaine and others, can increase your risk of having SCAD.

If you are in any of the above risk factors, it is essential to pay attention to your body and especially to your cardiac or heart health. Visit your medical facility if you notice any SCAD initial sign or symptom.

Remember, not everyone that experiences SCAD has any prior risk factor. Therefore, anyone, especially in the average age of 42 years, can have SCAD.

Symptoms of Spontaneous Coronary Artery Dissection?

As you may recall, we mentioned that SCAD's first symptom is near to a heart attack. Therefore, you should not waste time postponing visiting your doctor immediately. The onset of SCAD means insufficient blood supply to the heart muscles.

Therefore, every second towards treatment is precious to your heart to prevent heart attack or a sudden cardiac arrest.

You might notice one of the following symptoms or with a combination of another to alert you of SCAD. Since SCAD symptoms are almost similar to those of the commonly known heart attack, it is often underdiagnosed.

The following are some of the SCAD symptoms:

  • Heart Arrhythmia or rapid heartbeat
  • Chest pain, heaviness, or tightness
  • Pain in the jaw, shoulder, or arm
  • Extreme fatigue without any reason
  • Dyspnea or shortness of breath
  • Sweating profusely
  • Dizziness
  • Nausea

If you experience one or two of the above symptoms and suspect a heart problem, seek emergency support by calling 911 or any other emergency number.

Get yourself to the nearest hospital if you can't get through to an emergency support. Do not drive yourself to the hospital, but have someone else do so immediately. Every minute counts to your recovery.

Intravascular ultrasound performed cross-sectional and longitudinal of coronary artery.

How is SCAD diagnosed?

Diagnosing SCAD procedures are different, and it is up to your cardiologist to opt for a process best suitable for your condition. Since diagnosis precedes treatment, it is essential to give out for full information about your cardiac health or how you feel to get the right treatment.

The following are some of SCAD procedures that your cardiologist may carry on you:

Invasive Coronary Angiogram

The invasive coronary angiogram is to capture images of the coronary artery. For the coronary angiogram procedure, your doctor inserts a catheter or a long and thin tube inside your artery through your leg or arm.

Next, your doctor would thread the catheter through the femoral artery if using the leg or radial artery in your wrist then release some contrast dye by injection into your artery.

The doctor would then use an X-ray to capture images of any coronary artery abnormalities, as revealed by the dye.

Intravascular Ultrasound

Intravascular ultrasound is almost similar to an angiogram but a more precise procedure that aids a doctor in confirming SCAD.

Instead of the regular catheter used in an angiogram, intravascular ultrasound testing uses a special catheter with an imaging feature. Intravascular ultrasound, therefore, does not require an X-ray for images.

Optical Coherence Tomography (OCT)

OCT is another upgraded test to confirm results from coronary angiogram procedure. The catheter in this procedure is mounted with a special light to give clear images.

Cardiac Computerised Tomography (CT) Scan

During this CT scan or angiography, you lie inside an X-ray tube machine on a bed or table. The imaging machine rotates to capture images of your heart to reveal any abnormal condition of your arteries.

The four cardiac test procedures are some of the different types your doctor may opt to use before proceeding to treatment.Enter your text here ... 

Illustration of a catheter with a balloon and stent.

Spontaneous Coronary Artery Dissection Treatment

Restoring blood flow to your heart muscles is the main aim for urgent treatment. The severity of your SCAD condition from the diagnosed images would guide your doctor on the treatment process.

The following are some of the treatment procedures your cardiologist may prefer using:

The Natural Option. SCAD can sometimes heal naturally. If your condition is not severe and that blood is flowing through the affected coronary artery, your doctor may allow the dissection to heal naturally.

Medication. If the artery dissection is not a serious one but causes pain, your doctor may consider some suitable medicines to relieve you of any symptoms.

Stent and Balloon Procedure. If the bulging artery constrains the blood flow, your doctor may go for stent and balloon treatment.

Using a catheter, your cardiologist directs it to the injured coronary artery through either the leg or arm. A balloon and a stent are inserted through the catheter to your artery. X-ray images would be required for direction when inserting the balloon and the stent.

The balloon is then inflated, which then expands the stent. After that, it is deflated and removed to leave behind the stent, which remains to keep the artery open.

Coronary Bypass Surgery. Your doctor may consider an emergency coronary artery bypass grafting (CABG) surgery to save your life. The bypass creates a new artery in place of the dissected and probably blocked coronary artery.

The fixed artery helps to deviate the blood flow from the affected artery for continuity to the heart muscle.

Coronary bypass process would require an artery mainly from the leg or any other part of the body to graft it to the dissection area.

What would guide your doctor to choose the right treatment procedure? It is the condition of the artery dissection, the location, or if any other existing heart disease.

Spontaneous Coronary Artery Dissection Complications

SCAD is a highly fatal disease, just like most other heart diseases. Since it occurs instantly, it can cause myriad other complications besides tearing the artery wall layer. Some of SCAD complications are:

Heart Attack. The main complication of spontaneous coronary artery dissection is a heart attack. The constricted coronary artery blocks blood flow to damage the heart muscles to subsequently cause a heart attack.

Sudden Cardiac Arrest. A heart attack from spontaneous coronary artery dissection can lead to a sudden cardiac arrest.

Blood Clot. Blood flowing inside a torn layer of a coronary artery wall remains there to eventually form blood clots.

SCAD Recurrence. Even with successful treatment, SCAD can recur. It is, therefore, important to strictly keep to an after-treatment medical checkup schedule. Your doctor may keep a record of your recovery process while closely monitoring any recurrence.

Preventing SCAD

"How can I prevent SCAD?"

As we mentioned earlier, SCAD is ongoing research. Scientists are yet to find out what causes this mysterious heart condition. Likewise, the researchers do not yet know how to prevent SCAD.

However, if you are a one-time SCAD patient, you can prevent the condition from recurrence by doing the following:

  • Maintaining a healthy diet and weight to manage blood pressure
  • Avoid any emotional stress triggers
  • Observe regular but light exercises
  • Avoid pregnancy and any hormone therapy

Life After SCAD

If you can recall, we mentioned that SCAD could recur even after successful treatment. Changing your lifestyle and leaving a healthy life is essential for a SCAD patient to stay healthy and prevent SCAD recurrency.

You might find yourself worried when you can't do the things you used to do before SCAD. It can take longer for you to recover emotionally than you can physically.

Indeed, life can never be the same as it was before. Take heart. You can still lead a comfortable and healthy life as before.

You may consider the following points to propel you towards after-SCAD recovery:

  • Live a day at a time without revisiting what happened or what can happen in the future.
  • Avoid being emotionally stressed as much as you can. Be in close contact with your friends and family for company and emotional support.
  • Keep your doctor's appointments and take your medicines promptly.
  • Join a SCAD support group near you to meet and make friends with like-minded people.
  • Connect with other SCAD survivors online to share your experiences and to encourage one another. Your recovery journey begins by talking and sharing your challenges, your worries, and any other negative feeling.
  • Practice gratitude and be grateful to appreciate your life, family, friends, and everything around you.
  • Live your life to the fullest.
  • Exercise, eat well, and enjoy life. After all, you have so much to live for.

Key Points to Remember

  1. Spontaneous coronary artery dissection is often misdiagnosed due to a lack of information, leading to wrong treatment, especially to a young, healthy-looking patient.
  2. SCAD is a life-threatening condition that would require emergency attention from cardiac medical personnel after experiencing one or two SCAD symptoms. Visit a medical facility near you for proper diagnosis and early treatment, which is crucial for life-saving.
  3. The best SCAD treatment is leaving it to heal on its own with the support of certain medications as per your SCAD specialist recommendations.
  4. SCAD is often followed by extreme emotional stress.
  5. If you are a one-time SCAD patient, always remind your doctor of your previous SCAD condition before receiving treatment for another disease.
  6. SCAD is more likely to recur within the next few months of the initial occurrence. The good news is that you can continue leading a healthy life long after SCAD.
  7. "Listen to your body" - A quote by a SCAD survivor and a cardiology nurse, Kristin O'Meara. Diagnosing begins with you. Your doctor won't know how you feel unless you report it precisely. What you say is what will guide your doctor alongside other tests to make the right diagnoses.

Spontaneous Coronary Artery Dissection Heart Disease Complementary and Alternative Therapy

There are various alternative treatments for heart health issues. However, you may require consulting your health practitioner for the best therapy and advice. The following are some of the recommendations from our natural health practitioner, Yvonne Dollar Perc

Island Healthworks does DNA health testing, which could help detect this potential and many others.

DNA Testing

Island Healthworks does DNA health testing, which could help detect this potential and many others. If you are concerned that you might have the possibility, then give us a call, and we can set up a DNA health assessment test. Several Genes help promote a healthy heart, but these 2 Genes involved are essential in promoting Coronary Artery health. The most important is the Gene MTHFR, and the CYP11B2 Gene are critical factors in Heart Health.

Key Genes: MTHFR - Homocysteine/Folic Acid Gene or MTHFR rs1801133 / rs1801131 

​What is the purpose of the MTHFR Gene? A Healthy Heart depends on the MTHFR enzyme to maintain Healthy Homocysteine levels. Why? Homocysteine is harmful to the Endothelium of the Arteries and is very damaging to Neuronal Synapses, which increases the susceptibility to Ischaemic Strokes and arterial damage. A Healthy Heart depends on the MTHFR enzyme to maintain Healthy Homocysteine levels.

Key Genes: CYP11B2 - Healthy Blood pressure Gene or CYP11B2 rs1799998

What is the purpose of the CYP11B2 Gene? A Healthy Heart depends on the essential Gene CYP11B2 to help Maintain Blood Pressure in normal ranges. Hypertension is when the heart is working harder to pump blood through the arteries.

Live Blood Testing

Island Healthworks performs Live Blood Analysis. We look at dry blood samples specifically.

Blistering: Observed in Layer(s)

A localized area in the sample that appears raised/bulging. This pattern is connected to cardiovascular health challenges, including circulation problems, stress on the heart, high blood pressure, irregular heartbeats, narrowing of blood vessels, etc. We can also see crystals in the blood plasma. 

​Blistering is the pattern connected to cardiovascular health

The following are our recommendations for a healthy heart.

Rejuvenaid, 30 Packets - Helps to maintain proper muscle function and tissue formation and to form red blood cells, supports energy production, and helps to maintain heart muscle function.

CoQ10-100 mg (60 Softgels) - Helps to maintain and/or support cardiovascular health. Many Co-Q10 products are marketed in a crystalline state, a form in which the coenzyme's absorbability is far less than ideal. Nature's Sunshine uses a patented lipid blend to keep Co-Q10 from crystallizing, and it yields maximum bioavailability.

Gotu Kola (100 Caps) - Promotes circulation and supports connective tissues. Gotu kola is thought to support memory and brain function by promoting circulation. Conclusion

Call 911 in case you experience severe chest pain that moves to your jaw, shoulder, and arm, especially after strenuous activity or exercise. Don't wait until tomorrow to visit your doctor. Get emergency rescue to save you from a heart attack, heart damage, or a sudden cardiac arrest by immediately getting you to a hospital.

If you have any questions concerning this crucial information, we are ready to answer any of that. Do not hesitate to Ask Yvonne by following the simple steps laid down after opening the link. You might also want to discuss any other health condition apart from SCAD. It is simple, fill out the form, and will immediately get back to you.

You can also directly connect to Yvonne Dollard Perc on her office telephone number +250.4687685. Alternatively, you can email your concerns through our address: This email address is being protected from spambots. You need JavaScript enabled to view it..

If you care about your loved ones, you would want to share this information to raise awareness of spontaneous coronary artery dissection. Play your role in sharing the information to keep everyone healthy.

"The greatest wealth is health" - Roman Poet, Virgil. 


Yvonne Dollard Perc: Owner of Island Healthworks, Natural Health Practitioner, Teacher, Writer and Editor.

Elizabeth Njuguna: Researcher, Freelance Writer, with a Focus on Natural Health.

Sherry Robb: Print, Web and Social Media Designer specializing in the natural health and fitness industries.

Island Healthworks offers in-person and virtual consultations for assessment of your specific needs, with health & lifestyle coaching, featuring the best of integrative natural health care. To book your consultation, please call 250-468-7685!

This article is intended for educational purposes and the information contained within is not intended to treat, diagnose or cure any disease or health problem. Please seek appropriate medical attention for any health complaints. We cannot take responsibility for your health care decisions. Our intent is only to offer health information to help you with your search for better health. 

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Thursday, 01 October 2020