Spontaneous Coronary Artery Dissection (SCAD)

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Heart attacks during pregnancy or shortly after are rare. When they do happen, a common cause is spontaneous coronary artery dissection. In fact, spontaneous coronary artery dissection is the most common cause of pregnancy-associated heart attack.

Heart attacks typically are caused by a plaque blocking blood from reaching the heart muscle. Spontaneous coronary artery dissection can cause a heart attack, but does it differently and affects mostly women who may not have the common heart attack risk factors. As a result, in many women with spontaneous coronary artery dissection the condition was unrecognized.

Spontaneous coronary artery dissection is a tear in the layers of an artery’s wall. Blood flows under the tear, often making it larger, and pools there. As the area fills with blood, it expands and blocks blood flow.

The cause of spontaneous coronary artery dissection isn’t clear. Researchers suspect the cause is more likely related to hormonal changes after delivery affecting the vascular walls. Indeed, these heart attacks appear to happen more often in the first month after delivery.

Providing Specialized Care for a Woman’s Heart

At the Norton Heart & Vascular Institute Women’s Heart Program, our board-certified and fellowship-trained cardio-obstetrics specialists focus on heart conditions that are more prevalent among women, especially around pregnancy and menopause. Our physicians are at the forefront of research into heart conditions that tend to affect women more than men, and they have the experience and expertise to successfully treat conditions that perhaps have been overlooked in the past.

Women’s Heart Program providers work with your health care team, including your OB/GYN and maternal-fetal medicine specialist, to create a comprehensive care plan.

Common risk factors for heart attack don’t apply to spontaneous coronary artery dissection. Some people with the condition might dismiss symptoms since they don’t think they are at risk. New mothers often are focused on the health of their newborn and may put off addressing symptoms of heart attack.

Spontaneous coronary artery dissection affects women more than men, especially women around menopausal age. Young women in particular with no risk factors for common heart attack, but having symptoms like chest pain, may be evaluated for this disease.

Intense emotional stress, heavy lifting or straining, labor and delivery, and use of hormone-containing drugs or therapies, have been reported to cause spontaneous coronary artery dissection.

If you have chest pain or think you’re having a heart attack, call 911. Don’t attempt to drive yourself to an emergency room.

Symptoms of Spontaneous Coronary Artery Dissection

Symptoms are similar to heart attacks in general and can include:

  • Chest pain or discomfort at the center of the chest that persists for more than a few minutes. It can feel like pressure, squeezing or pain.
  • Common heart attack symptoms in women include:
    • Shortness of breath
    • Nausea or vomiting
    • Jaw pain
  • Arm pain or discomfort
  • Lightheadedness or dizziness
  • Cold sweat

What to Expect at Norton Heart & Vascular Institute Women’s Heart Program

  • Specialized cardio-obstetrics expertise in preventing and caring for heart conditions focusing on the times surrounding pregnancy and menopause.
  • Comprehensive care for conditions that have unique risks and implications for women, including high blood pressure, atrial fibrillation, ischemic heart disease and spontaneous coronary artery dissection (SCAD).
  • Board-certified cardiologists with specialized experience and focus on women’s heart health are dedicated to serving as advocates for conditions that are often can go unrecognized.
  • The women’s heart health specialists are part of a team of providers dedicated to your health, including close collaboration with Norton Women’s Care and Norton Children’s Maternal-Fetal Medicine, providing high risk pregnancy care.
  • Medicare, Medicaid and most major commercial insurance plans accepted.
  • Book appointments, get alerts when an earlier appointment becomes available, communicate with your medical provider, refill prescriptions and more through your free Norton MyChart account.

Reviewed by Li Zhou, M.D.

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