Spontaneous Coronary Artery Dissection (SCAD)

Spontaneous coronary artery dissection (SCAD) is a rare and potentially life-threatening medical condition that occurs when there is a tear in the inner lining of one of the coronary arteries, which supply blood to the heart. This tear causes a separation or dissection of the layers of the artery wall, leading to a reduction or blockage of blood flow to the heart.

Causes and Risk Factors

The exact cause of SCAD is not fully understood, but it is thought to be related to a combination of factors, including:

• Weakness in the artery wall, which can be due to genetic conditions or other medical conditions such as fibromuscular dysplasia
• Hormonal changes, particularly during pregnancy or menopause
• High blood pressure
• Physical stress or trauma
• Certain medications, such as those used to treat migraines or high blood pressure

Symptoms

The symptoms of SCAD can vary depending on the severity of the condition and the location of the tear. Common symptoms include:

• Chest pain or discomfort, which may feel like a heart attack
• Shortness of breath
• Dizziness or lightheadedness
• Nausea or vomiting
• Fatigue

Diagnosis

SCAD can be difficult to diagnose, as the symptoms are often similar to those of a heart attack. Diagnostic tests that may be used to confirm SCAD include:

• Coronary angiography, which uses X-rays and dye to visualize the coronary arteries
• Intravascular ultrasound (IVUS), which uses sound waves to create images of the inside of the artery
• Optical coherence tomography (OCT), which uses light to create detailed images of the artery

Treatment

The treatment for SCAD depends on the severity of the condition and the location of the tear. Treatment options may include:

• Medications, such as blood thinners or medications to lower blood pressure
• Angioplasty and stenting, which involves using a balloon to open up the blocked artery and placing a stent to keep it open
• Surgery, such as coronary artery bypass grafting (CABG), which involves bypassing the blocked artery with a healthy blood vessel

Prognosis and Complications

The prognosis for SCAD is generally good if treated promptly and effectively. However, there are potential complications that can occur, including:

• Heart attack or myocardial infarction
• Cardiac arrest
• Death

It is essential to seek medical attention immediately if symptoms of SCAD occur. Prompt treatment can help prevent complications and improve outcomes.