Description

Spontaneous coronary artery dissection is an emergency condition that occurs when a tear forms in the wall of an artery of the heart. Spontaneous coronary artery dissection is also called SCAD .

(SCAD) can slow or block the flow of blood to the heart, causing a heart attack, heart rhythm problems or sudden death.

(SCAD) most commonly affects women in their 40s and 50s, although it can occur at any age and can occur in men. People who have SCAD often do not have risk factors for heart disease, such as high blood pressure, high cholesterol, or diabetes.

SCAD can cause sudden death if not treated in time. Get emergency medical help if you have signs of a heart attack — even if you think that you're not at risk of a heart attack.

Symptoms

The symptoms of SCAD may include:

  • Chest pain or pressure.
  • Pain in the arms, shoulders, back, or jaw.
  • Shortness of breath.
  • Sweat.
  • Extreme tiredness.
  • Upset stomach.
  • A fast heartbeat or uneasy feeling in the chest.
  • Feeling of dizziness.

When to see a doctor

Call 911 or the local emergency number if you have chest pain or think you may be having a heart attack. If you do not have access to emergency medical services, have someone drive you to the nearest hospital. Do not drive yourself unless you have no other choice.

Causes

The cause of spontaneous coronary artery dissection is unknown.

Risk factors

Risk factors for SCAD include:

  • The fact of being a woman. SCAD can happen to anyone. But it tends to affect women more than men.
  • Delivery. Some women who have had SCAD have recently given birth. This may be due to changes in hormones and stress on the blood vessels. SCAD has been found to occur more frequently in the first few weeks after delivery. But SCAD may also occur during pregnancy.
  • The extreme tension. SCAD can happen after extreme stress. This includes intense physical exercise and severe emotional distress.
  • Fibromuscular dysplasia (FMD). This condition causes the weakening of the medium-sized arteries. FMD can lead to problems in the arteries, such as aneurysm or dissection. Women are more prone than men.
  • The genetic disorders that affect the connective tissue. The Ehlers-Danlos syndrome and Marfan's syndromes have been found in people who have had the SCAD .
  • Very high blood pressure. Severe high blood pressure can increase the risk of SCAD .
  • Use of illegal drugs. The use of cocaine or other illegal drugs might increase the risk of SCAD .

Complications

A possible complication of SCAD is a heart attack. SCAD slows down or stops the flow of blood through an artery. This weakens the heart and can lead to a heart attack. An attack on the heart of the SCAD is different from a heart attack caused by a buildup of fats, cholesterol and other substances in the walls of the arteries. This condition is called atherosclerosis.

In some people with SCAD , the inner and outer layers of the artery can be divided. The blood can build up between these layers. The pressure of the accumulation of blood can make SCAD worse.

Even with the success of the treatment, mackerel, horse MACKEREL can happen more than once. It can occur shortly after the first episode or years later. People who have SCAD may also have an increased risk of other heart problems. These problems include heart failure because the heart attack damage.

Diagnosis

SCAD is usually diagnosed in an emergency setting. Questions will be asked about your personal and family medical history. Tests are done to check your heart.

Tests

Tests to diagnose SCAD are similar to tests for the detection of a heart attack. They may include:

  • Blood tests. Some proteins will slowly leak into the blood after heart damage from a heart attack. Blood tests can check for these proteins. Other blood tests may also be done.
  • Electrocardiogram (ECG or EKG). This quick test checks the electrical activity of the heart. We can show you how fast or how slow the heart is beating. Sticky patches called electrodes are attached to the chest and sometimes the arms and legs. An electrocardiogram (ECG) can determine if you are having or have had a heart attack.
  • The coronary angiography. This test looks at the inside of the arteries of the heart. A doctor inserts a long, thin, flexible tube called a catheter into a blood vessel, usually in the groin or wrist. Is guided into the heart. Contrast medium flows through the tube to the arteries. The dye helps the arteries are shown more clearly in the images and the video. A coronary angiography can diagnose SCAD . You can also show any of the braiding of the arteries.

Other tests may be done during a coronary angiography to confirm the SCAD and the treatment plan. These tests include:

  • The optical coherence tomography (OCT). This test uses the light to see the inside of the blood vessels and the walls of the blood vessels. The doctor inserts a flexible tube called a catheter into a blood vessel and the guide for the heart. A ray of light that shines from the catheter. The test can help to accurately diagnose the cause of a heart attack.
  • Intravascular ultrasound (IVUS). Use sound waves to make pictures of the inside of the arteries of the heart. The doctor inserts a flexible tube called a catheter into a blood vessel and the guide for the heart. A device at the end of the probe emits sound waves. A computer that is seen in the sound waves that bounce off and turns them into images of the arteries of the heart.

Treatment

The objectives of the SCAD treatment are:

  • To restore the flow of blood to the heart.
  • Managing pain in the chest.
  • Prevent the SCAD that to happen again.

Treatment may include medicines and a procedure or surgery to open the artery and restore blood flow. Sometimes SCAD healthy on your own.

The type of treatment for SCAD depends on the general health and the size and location of the rupture of the artery.

Drugs

Some people with SCAD only need medications to treat the symptoms. If the chest pain or other symptoms continue, other treatments may also be required.

Medications to treat the SCAD may include:

  • The aspirin. Taking long-term aspirin can help reduce the risk of diseases of the heart after SCAD . Talk with a health professional to decide if the therapy of aspirin daily is right for you.
  • Blood pressure medications. Several medications are available to lower the blood pressure. You might need to take these drugs for life to reduce the risk of another SCAD .
  • Medications to control pain in the chest. Medicines called nitrates and calcium channel blockers can help to treat chest pain after SCAD .

Surgery or other procedures

Some people with SCAD need of a surgery or procedure of revision of the artery and improve the blood flow to the heart. These treatments may include:

  • Coronary angioplasty (AN-jee-o-plas-tee) and stenting.This may be necessary for the treatment ifSCADblocks the flow of blood to the heart or medications don't control your chest pain. During the procedure, a doctor inserts a long, thin, flexible tube called a catheter into a blood vessel, usually in the groin or wrist. Is guided into the heart. A small balloon at the tip of the catheter stretches to open the artery. Then, the doctor will put a small mesh tube called a stent inside the artery. The stent keeps the artery open and improves the flow of blood. The balloon is removed. The stent remains in place.
    Another name for this treatment is percutaneous coronary intervention, or PCI.
  • Coronary artery bypass surgery. This open-heart surgery creates a new pathway for the flow of blood around a blocked or partially blocked artery. It may be done if other SCAD treatments don't work, or if you have more than a few tears. The surgeon takes a healthy blood vessel from the chest or in the area of the leg. This healthy vessels is a graft. One end of the graft is sewn to the artery below the blockage. The other end is stitched to the heart. Other names for this surgery include coronary artery bypass surgery, coronary artery bypass graft surgery, or CABG — pronounced "cabbage."

Coronary angioplasty (AN-jee-o-plas-tee) and stenting. This treatment may be necessary if SCAD blocks the flow of blood to the heart or medications don't control your chest pain.

During the procedure, a doctor inserts a long, thin, flexible tube called a catheter into a blood vessel, usually in the groin or wrist. Is guided into the heart. A small balloon at the tip of the catheter stretches to open the artery. Then, the doctor will put a small mesh tube called a stent inside the artery. The stent keeps the artery open and improves the flow of blood. The balloon is removed. The stent remains in place.
Another name for this treatment is percutaneous coronary intervention, or PCI.

Pregnancy

If you have had SCAD , talk with a health care professional before you get pregnant. The pregnancy may not be safe after SCAD .

Cardiac rehabilitation

After treatment for horse MACKEREL , they need regular checkups with your health care team.

A customized program of exercise and education can be suggested. This is called the cardiac rehabilitation, also known as cardiac rehabilitation. It is created to help you recover from a serious heart disease. The program often includes supervised exercise, emotional support and education about a healthy diet for the heart.

Lifestyle and home remedies

It is important to take measures to keep the heart healthy. Try these tips:

  • Do not smoke. Smoking is a major risk factor for heart disease. Not smoking is the best way of reducing the risk of heart disease and its complications. Also stay away from second hand smoke. If you need help quitting, ask your care team strategies that can help.
  • Eat healthy foods. Choose whole grains, fruits, vegetables, and lean proteins such as fish and beans. Avoid or limit foods that are high in saturated fats, trans fats, salt and sugar.
  • Exercise. Regular exercise helps to control diabetes, high cholesterol, and high blood pressure — all risk factors for heart disease. With your provider to ACCEPT, the goal is 30 to 60 minutes of physical activity most days of the week. Talk with your health care provider about the amount and type of exercise is best for you. You may be told to avoid the intense lifting, competition, and extreme temperatures.
  • Maintain a healthy weight. Too much weight strains the heart. Being overweight increases your risk of high cholesterol, high blood pressure and diabetes.
  • Limit the consumption of alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women and up to two drinks per day for men.
  • Control of blood pressure, cholesterol and blood sugar. Ask your health care team how often you need to have your blood pressure, blood sugar and cholesterol levels.
  • Practice good sleep habits. Lack of sleep can increase the risk of heart disease and other health problems. Adults should aim to get 7 to 9 hours of sleep daily. Go to bed and wake up at the same time every day, including weekends. If you have trouble sleeping, talk with a health professional about strategies that might help.
  • Manage stress. Find ways to help reduce emotional stress. Do more exercise, the practice of mindfulness and connecting with others in support groups are some of the ways to relieve stress.

Coping and support

Some people might feel scared, sad, frustrated, or depressed after SCAD . Understanding your health and talking to others can help. Try these tips:

  • Learn aboutSCAD. The knowledge of the details may make you feel more comfortable talking with your health care team. Ask about the size of the artery, lacrimal and where it is. To understand the treatments they are receiving and why you need them. Ask where you can find more information.
  • Join a support group. It can be useful to connect with other people who know what is going on. Ask your health care team if there are any horse MACKEREL or heart disease support groups in your area.

Preparing for your appointment

You may not have time to prepare. SCAD is usually diagnosed in an emergency situation. If you have chest pain or think that you're having a heart attack, immediately call 911 or your local emergency number.

After a SCAD diagnosis, you may have questions about your health. Prepare a list of questions to ask your doctor at your next appointment, such as:

  • What made my SCAD ?
  • What tests do I need?
  • What is the most appropriate treatment?
  • It is the tear in my artery heals by itself?
  • What is my risk of having another SCAD ?
  • I have a condition of the blood vessels, such as fibromuscular dysplasia, also called foot and MOUTH disease?
  • I have other health conditions. How can I best manage them together?
  • Is there any activity or dietary restrictions I need to follow?
  • It is safe for me to become pregnant?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Don't hesitate to ask other questions you have.

Symptoms and treatment of coronary artery dissection, Spontaneous (SCAD)