Medically reviewed by
Dr. Anil Om
McLeod Cardiology Associates Seacoast

Spontaneous Coronary Artery Dissection (SCAD) is as bad as it sounds. The number one cause of heart attack for women under age 50, as well as the number one cause of heart attack in pregnant women and new mothers.

“There’s a sudden tear in the layers inside one of the arteries leading to the heart, most often the left anterior descending artery,” says McLeod Cardiologist Anil Om, MD. “When the walls split, they block blood trying to get to the heart, possibly resulting in a heart attack. When a young, seemingly healthy woman experiences what would otherwise be diagnosed as heart attack symptoms, it can be viewed as a gastric problem or panic attack. A heart catheterization is often the only path to a conclusive diagnosis.”

WHO’S AT RISK
Researchers continue looking for a likely cause. It’s difficult to diagnose, because there are often few, if any, heart attack warning signs. Symptoms that do appear include pressure in the chest, shortness of breath, sweating and dizziness.

Severe physical or emotional stress, as well as extreme physical exertion, can trigger SCAD. Hormonal infertility treatments and powerful migraine headaches might also precede internal dissection in a key artery. Another cause can be fibromuscular dysplasia, a condition weakening artery walls.

Due to blood pressure issues related to pregnancy, five to ten percent of total SCAD cases strike pregnant women with the damage possibly more severe than in women, who are not pregnant. Once SCAD batters a woman, there is likely to be a recurrence. She should alert her physician if any symptoms appear.  If a woman suffered SCAD while pregnant, a second pregnancy would be treated as high risk.

TREATMENT
If discovered before a severe heart attack, SCAD is treated with blood pressure control and blood-thinning medications.  If these treatments fail, stent or bypass surgery represent the next step. Surgical treatment includes re-opening the artery and inserting a stent (small tube) to keep it open.

ACTION YOU CAN TAKE
If you’re a young woman experiencing chest pain, call 911 or go directly to the Emergency Department.  If you’ve suffered SCAD, have your personal physician and a cardiologist follow you closely to avoid a second incident.

Find a Cardiologist near you.

Sources include: McLeod Health, Netherlands Heart, USNews & World Report, NPR Health, SCAD Research Foundation, National Coalition for Women with Heart Disease, American Heart Association