What is a SCAD heart attack?
Spontaneous Coronary Artery Dissection (SCAD) is an uncommon emergency heart condition that occurs when a tear forms in one of the blood vessels in the heart, which causes a clot to form within the wall of the blood vessel. As the clot expands, the wall of the artery bulges into the vessel, which blocks or slows blood flow to the heart, causing a heart attack, abnormalities in heart rhythm or sudden death.
SCAD often occurs in people who aren’t ‘typical’ heart attack patients– healthy & fit women (and much less commonly, men), who lead an active lifestyle and often have no family history of heart disease.
|SCAD IS NOT||WHAT WE KNOW ABOUT SCAD|
|SCAD is NOT caused by traditional risk factors such as high cholesterol, high blood pressure, obesity or physical inactivity.||The cause/s of SCAD for many people is still unknown.|
|Heart condition requiring urgent treatment|
|Much more common in women than men|
|70% of cases occur in those aged under 50 years with the average age of sufferers between 45-52|
|10-15% of cases associated with pregnancy most commonly in the first week after delivery.|
|Extreme physical activity or major emotion stress has been associated with SCAD|
|Fibromuscular dysplasia (FMD) often occurs in association with SCAD, and can increase the risk of dissection or blockage of arteries outside the heart, such as those supplying blood to the kidneys or brain.|
|SCAD is the leading cause of heart attacks in women under 50 and in new mothers.|
Regardless of your age, gender or fitness levels, if you or someone you know if suffering heart attack symptoms, call Triple Zero (000) immediately.
– Source: the Mayo Clinic
- SCAD is a heart condition which requires urgent treatment
- SCAD is more common in women than men
- 70% of SCAD cases occur in people under age 50 years, and has occurred in individuals in their teens
- SCAD typically occurs in people with no standard risk factors for heart attack (such as high cholesterol, high blood pressure and diabetes); the underlying cause of SCAD is unknown in most patients
- Pregnancy is an associated condition: 10-15% of SCAD cases in women occur most commonly in the first week after delivery of a baby
- Extreme physical activity or emotional stress has been associated with SCAD
- Certain genetic mutations and a related condition called fibro muscular dysplasia (FMD) can increase the risk of dissections of arteries in other parts of the body
- SCAD can recur which can create a high level of uncertainty and anxiety for SCAD Heart Attack Survivors: up to 30% of patients will experience another SCAD over a 10-year follow-up period
Source: the Mayo Clinic
A major challenge in diagnosing a SCAD heart attack is getting health care practitioners to see beyond the young, seemingly healthy individual. If your GP or medical practitioner has not treated SCAD patients in the past, please refer them to the ‘For Healthcare Professionals’ page on this site for the latest on diagnosing SCAD and best treatment practices.
How will you be diagnosed with a SCAD heart attack?
To diagnose a spontaneous coronary artery dissection, your doctor may order the following tests after reviewing your symptoms:
- Blood tests – specifically testing for troponin levels, the protein in your blood stream which indicates heart muscle damage
- Coronary angiogram –this is a special x-ray where dye is injected into your arteries supplying blood to the heart muscle. This may be done via a tube (catheter) in an artery at the wrist, or the groin. An angiogram will show any blockages in these arteries and possibly a tear within the artery wall
- Electrocardiograms (ECG)– electrodes are attached to the skin on your chest, arms and legs to check how your heart is functioning by measuring the electrical activity of the heart
- CT scans – this is like a coronary angiogram. It has the advantage of not requiring a tube to be inserted into an artery but is less precise than a coronary angiogram.
- Echocardiogram-Ultrasound waves from a probe placed on the chest used to look at the heart structures and the pumping action of the heart
Is cardiac rehab recommended if you’ve suffered a SCAD heart attack?
Cardiac rehabilitation is definitely recommended after surviving a SCAD heart attack. Each case of SCAD will be different, which is why a customised program is vital in easing your way back into a normal routine. A cardiac rehabilitation program often includes monitored exercise, nutritional counselling, emotional support and education.
At SCAD Research Inc we’re firm advocates for Cardiac Rehab following a SCAD Heart Attack. Cardiac Rehab has a number of benefits for SCAD survivors, namely:
- Providing a safe environment to exercise and improve physical fitness, energy and strength;
- Increased confidence in your capabilities & physical limits post SCAD;
- Improved emotional wellbeing through professional support and the benefits associated with physical exercise.
Your doctor may also suggest alternate types of care to help with your recovery.
What are the types of medications you should avoid?
If you suffer from migraines, which are commonly associated with SCAD, the use of triptans as drugs to treat migraine should be avoided. Your GP and Chemist will be able to guide you on the best alternative medications for you.
Since it is believed that there is a hormonal link to SCAD, you may be directed to take a non-hormonal form of birth control and avoid taking any hormone therapies.
What is cardiac rehabilitation?
Cardiac rehabilitation is a coordinated program of care which helps people return to an active and satisfying life after having a heart attack or heart event. By attending rehabilitation, patients can also meet other people going through similar experiences.
Participating in cardiac rehabilitation needs to be a first critical step in a person’s recovery from their heart attack or heart event.
Cardiac rehabilitation is a recommended part of your clinical care. It is a valuable part of your recovery and helps you make the necessary changes to minimise having another heart event.
Why does cardiac rehabilitation help?
Cardiac rehabilitation can help you recover and get back to normal activities sooner. You’ll get personalised support about:
- learning more about your heart condition and treatment
- getting back to your usual activities (e.g. work, driving, having sex)
- changing your lifestyle to improve your heart health
- managing your medicines
- knowing warning signs and what to do in an emergency.
You’ll be able to ask questions about things that may worry you, and get support if you feel stressed, anxious or depressed.
How do cardiac rehabilitation programs work?
Cardiac rehabilitation usually runs for 6 to 10 weeks. It often starts in hospital and continues when you go home. Programs can be run in different ways and places, for example:
- over the telephone
- on the internet
- in a group or one-on-one
- in hospitals, community centres or clinics
- in your home.
To Contact a Cardiac Rehabilitation Program in your area call the Australian Cardiovascular Health & Rehabilitation Association on +612 9431 8653 or the Heart Foundation www.HeartFoundation.org.au
FAQs for SCAD patients
The same as for any heart attack, although they may differ between men and women. Women are more likely to experience pain in their jaw, neck or back, nausea and feeling light headed or unusually tired. If you’re not sure whether you could be having a heart attack, please seek urgent medical advice and make sure you tell the doctor, nurses or paramedics about your previous SCAD Heart Attack.
Image Source: The Heart Foundation
If you experience shortness of breath or sustained pain for longer than 5 minutes, call triple zero (000) and inform them that you have previously had a SCAD heart attack.
Depending on the severity of your SCAD, you should be able to return to exercise starting with cardiac rehabilitation. Even if you are back to a similar pre-SCAD exercise routine, we do not recommend going running alone or exercising in isolated areas.
However, the people who had their SCAD episode whilst exercising rigorously should return to exercise very slowly and avoid workouts, such as weightlifting (isometric exercise), which is known to increase blood pressure.
According to studies, there is an approximate 30% chance of reoccurrence over a 10 year time frame. The survival rate for subsequent heart attacks is very high as survivors are aware of the symptoms and call triple zero (000).
As each case of SCAD is different, each person’s ability to return to their normal routine will vary. By undertaking cardiac rehabilitation and talking to your clinician, you should be guided to when an appropriate time will be to return to sexual activity.
Unfortunately, there is no good information about this issue, but the good news is that most SCAD tears heal within a few months. This will depend on the size and complexity of the tear.
People can generally drive a few days after they are dismissed from hospital unless cautioned to wait longer by their doctor.
“If you have had an episode of SCAD, most doctors recommend that you avoid pregnancy altogether and use a non-hormonal form of birth control, such as an intrauterine device. Some heart medications can harm an unborn child and some SCAD complications can significantly increase a mother’s risk of carrying a baby to term. The decision to become pregnant is a serious one and should be made in concert with your cardiologist to assess your cardiac risks, maternal-fetal health specialists to assess a baby’s risk and with a recognition that there is an increased risk for recurrent SCAD with a pregnancy.
Living with SCAD
Coping & support: Your New Normal
Experiencing a SCAD heart attack can be an extremely unexpected and frightening event. Seeing that this condition often affects people who have very few or no risk factors for heart disease it can be very scary for the sufferer and their families. The good news is that the prognosis for those treated in a hospital is excellent and generally the tear in the coronary artery heals within 35 days..
Every case is different – you will likely feel more fatigued or tired for some time after your SCAD. Some people take up to 3-6 months or more to find their new normal. Some SCAD survivors experience mild unexplained chest pain following their heart attack – it is important to give yourself time to recover to undergo cardiac rehabilitation and to seek urgent medical advice if you have any concerns.
Some tips can include:
Manage stress and anxiety
Don’t ignore your mental health: A lot of the time your SCAD diagnosis will come as a shock, and with that it will be normal to experience some level of stress and anxiety. It is understood that there could be a connection between stress and SCAD, so it’s important you find ways of managing the stress and anxiety in your life.
A few ways to do this includes:
- Talk to someone
Whether it be a psychologist, GP or family member it’s important to talk about what you’re feeling and voice any fears or concerns you have about your health that may be causing you stress or anxiety
- Take care of yourself
Help your body recover by making sure you have enough sleep, eat a healthy balanced diet and find ways to cope with stress (e.g. trying meditation, listening to music). If your SCAD occurred in association with vigorous exercise, in which case you should avoid intense, particularly isometric, exercise for several months, otherwise, don’t severely limit activity, especially if the activity reduces stress.
- Connect with others living with SCAD. Join a community that understands what you’ve been through. There is an Australian Facebook group for SCAD survivors, connecting women & men from around the country who have been through similar experiences. There are also Facebook Support groups from family members of SCAD patients.
SCAD Research Inc Australia also holds 5k SCADaddles for research walks across Australia. These walks are a great opportunity to meet other survivors and their friends and family as well as raising much-needed funds for medical research into SCAD heart attacks.
It is perfectly normal to need time to accept what has happened to you and to come to terms with changes in your everyday life. In fact, anxiety or depression after a cardiac event is so common that it even has a name – post cardiac or situational depression, which may even mimic post-traumatic stress disorder – the good news is that it’s common, treatable and often temporary.
Each person will have a different way of dealing with, and understanding their diagnosis, but it’s important that you do take the time in processing your SCAD heart attack and build yourself back up to your ‘new normal’.
If you or someone you know would like further support or to find out more about anxiety and depression go to https://www.beyondblue.org.au/ or call Beyond Blue Australia on 1300 22 4636 for support & advice.
Join the Victor Chang Cardiac Research Institute’s SCAD research program:
The Victor Chang Cardiac Research Institute is leading Australian research into spontaneous coronary artery dissection (SCAD) to try and understand the cause of this disease. Currently, there isn’t much known about SCAD, which is why research is so important.
Executive Director of the Victor Chang Cardiac Research Institute, Professor Bob Graham, is leading this research program which now has hundreds of Australian SCAD survivors, including some families with more than one affected member participating. The Institute’s researchers are looking to identify genetic variations that contribute to the development of this disease, and they need your help!
If you have had a SCAD heart attack and would like to find out more about how you can get involved in this research program, please email email@example.com.
Join the Mayo Clinic SCAD Research Program:
Mayo Clinic’s Spontaneous Coronary Artery Dissection (SCAD) Research Program is part of an innovative multidisciplinary collaborative research and clinical practice initiative formed in 2010. The goal of the program is to advance the understanding of the underlying causes and risk factors for SCAD and develop solutions for optimal diagnosis, treatment and prevention.
The international Mayo Clinic SCAD Research Program was created in response to data collection and a research agenda initiated by SCAD survivors via social networking. The study population is the largest known SCAD registry in the world.
Register to join many Australian SCAD survivors in this SCAD Study at Mayo Clinic by emailing firstname.lastname@example.org