SCAD heart attacks are rare, but target young, healthy women

SCAD heart attacks are rare, but target young, healthy women
A rare type of heart attack has been labelled “mysterious” and “devastating” — and it targets young, healthy women.

Spontaneous coronary artery dissection (SCAD) heart attacks happen when there’s a tear in one of the layers of the artery wall.

“It’s not that it has jumped out of nowhere, we’ve always known it’s been present,” she explained. These days, she said, when a patient has a heart attack, they tend to go a catheterization laboratory (or cath lab) to examine their arteries with a dye test, which can determine the type of heart attack the patient has.

“That wasn’t as accessible and available in the past,” she said. “Now we know a number of women were presenting with [SCAD] in the old days where cath wasn’t readily available and they would’ve been dismissed.”

Chest pain, she added, was often dismissed as “normal,” so one of the reasons SCAD is more identifiable now is that technology is able catch it.

“It was always there, we were just never able to see it.”

Symptoms of SCAD, like a heart attack, include chest pain, shortness of breath, sweating or nausea.

A recent report in Medscape added the tear in the artery ultimately blocks blood flow to the heart, causing a heart attack . Rambihar added the tear can be about four centimetres, keeping in mind a coronary artery can be 13 centimetres.

But SCAD is still considered rare. “Although SCAD causes a small percentage of heart attacks overall, it’s responsible for 40 per cent of heart attacks in women under the age of 50. And it mostly happens to women. More than 90 per cent of SCAD patients are female,” Medscape noted.

In 2017, researchers in Alberta added there were at least

“This is an important cause of heart attacks among younger people, and it has really only been in the past five or so years that our thinking on it has changed. For the past 100 years, we had been missing it,” Dr. Sharonne N. Hayes, a leading SCAD researcher at the Mayo Clinic, told Medscape.

“SCAD is happening to a group of women who appear healthy, are thin, and have no risk factors. So even though they have classic heart attack symptoms, they are often being misdiagnosed,”

Rambihar said the biggest problem with these cases is the lack of data, but there are some experts out there doing the research.

The Canadian SCAD study has been following women since 2014, and hopes to wrap up its findings in 2020. The study will look at the “natural history of the condition, predisposing medical conditions (that can result in a heart attack), treatment strategies and long-term cardiovascular outcomes,” authors noted.
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