When an older woman has a heart attack, it is almost always the result of Coronary Artery Disease (CAD). But often, heart attacks among young women present without evidence of heart disease at all.
That’s because a common cause of heart attacks among young women is Spontaneous Coronary Artery Dissection or SCAD.
According to Cleveland Clinic’s vascular medicine specialist, Dr. Esther Kim, the typical SCAD patient is a female in her 40’s to 50’s, although it may occur at a younger age.
In SCAD, the lining of a coronary artery rips, allowing blood to seep between the layers. This causes a blockage or a blood clot that produces severe chest pain or heart attacks among young women.
In some patients, it causes an electrical malfunction of the heart that results in sudden death. That’s why identifying people at risk for SCAD is so important.
Risk factors for heart attacks among young women: Spontaneous Coronary Artery Dissection
- In addition to pregnancy, having recently given birth or simply being female, there is evidence linking SCAD to connective tissue disorders.
- Systemic inflammatory conditions such as Lupus have also been associated with SCAD.
- New findings suggest that 60-80% of patients with SCAD may have other vascular diseases such as fibromuscular dysplasia(FMD), that targets young and middle-aged women.
SCAD can also affect extreme athletes, people with very high blood pressure and cocaine users.
So little is known about SCAD that most cardiologists don’t recognize it or know how to treat it.
That’s why it’s important to see a specialist who has experience in vascular disease and in diagnosing and treating SCAD if you’ve survived an unexplained heart attack or have one of the risk factors for SCAD.
- While many of these dissections heal on their own, medications to protect the arteries from stress are the preferred mode of treatment.
- If chest pain does not respond to medications, stenting may be the last resort.
A team approach should be used to evaluate and treat Spontaneous Coronary Artery Dissections.
The team should include:
- An exercise physiologist (CEP)to prescribe a safe exercise program
- A psychiatrist to treat anxiety
- A rheumatologist to treat any underlying immune disease
- A geneticist to help decide if a genetic disorder may have caused the SCAD event.
Spontaneous Coronary Artery Dissection is the result of another disease, but if doctors don’t check for it, it can go undiagnosed and may lead to potentially preventable cardiac events.