Information for SCAD survivors

Spontaneous Coronary Artery Dissection (SCAD) typically affects young, healthy adults so if you or a loved one have been diagnosed with SCAD and told how rare it is, you are probably feeling an array of emotions... frightened, confused, anxious, traumatised, angry...  It is completely normal to feel one or all of these emotions... you may also feel alone.
 
Our aim is to provide information and support to help you cope with your diagnosis and reduce the anxiety and isolation.
 
Understanding the medical condition you have been diagnosed with can help to reduce the worrisome feelings while you convalesce and adjust.  When the medical condition is rare, like SCAD, there are many unanswered questions. Good news... medical researchers are looking for answers and YOU can help – register your interest in the research by completing the form in the 'Help our research' section of this website.
 
The SCAD Research, Inc. website has a list of Frequently Asked Questions and an informative Factfile for Patients which includes ‘Tips for coping with your SCAD diagnosis’ – available at http://www.scadresearch.org/about/
 

SCAD may result in:

  • Angina (chest pain)
  • Myocardial Infarction (heart attack)
  • Sudden Cardiac Arrest
 

SCAD types:

  • Dissection flap: where a split or separation develops between the layers of artery wall and a loose flap of tissue causes a blockage and impedes normal blood flow
  • Intramural haematoma: where the artery wall is damaged and a collection of blood leaks into the tissue causing a swelling which blocks blood flow

One or both types may be present.  One or more coronary arteries may be affected.

 

Treatment of SCAD

The optimal treatment strategy for SCAD is largely undetermined but the primary goal of the interventionist is to open up any artery blockage to restore blood flow and minimise heart muscle damage – you may hear cardiologists say “Time is muscle” and it really is... the sooner treatment can be started, the better the chance of damage limitation.
 
Treatment will vary according to the individual patient’s circumstances: the type of SCAD event and the severity of presenting symptoms.

Following diagnosis of SCAD during the coronary angiography, treatment may be:

  • Conservative i.e. medically managed with no surgical intervention
  • Percutaneous Coronary Intervention (PCI) i.e. stent placement
  • Coronary Artery Bypass Grafting (CABG – “cabbage”)

 

Medications

Most SCAD patients will be started on a number of medications, typically:

  • Aspirin
  • Clopidogrel (Plavix)
  • A beta blocker e.g. Bisoprolol
  • An ACE inhibitor e.g. Ramipril

And possibly:

  • A long acting oral nitrate e.g. Isosorbide mononitrate
  • A statin e.g. Atorvastatin
  • A calcium channel blocker e.g. Diltiazem
 
Dosage and duration of use varies from patient to patient depending on their circumstances and needs.  Aspirin, beta blocker and ACE inhibitor will usually be prescribed for life.  Prescribed medications should not be adjusted or stopped without first discussing with a doctor.
 
Adjusting to this new medication regimen can be extremely difficult for a SCAD patient.  Medications which lower blood pressure, which may already be at a low-normal level, can leave a SCAD patient feeling tired with no energy.  Be aware of potential side effects by reading the information leaflets supplied with medications and report any concerns to your doctor or pharmacist.
 

Effects of SCAD

As SCAD can result in different types of coronary event, the resulting effects vary from patient to patient and depend on how quickly the event is diagnosed and treated.

One of the biggest problems facing SCAD patients is event identification and there are two sides to this:

 
  1. The individual, or those around them, may not recognise or suspect their symptoms to be cardiac and this can result in a delay seeking medical attention.
  2. The medical professional(s) assessing the patient also may not suspect a cardiac event when the individual appears to be “too young” or “too healthy” with no traditional risk factors for cardiovascular disease, or SCAD may be missed on the coronary angiography resulting in misdiagnosis.

Some patients do fully recover and are able to return to the activities they performed before their SCAD; others recover well with some adjustments to their life; but others are more severely affected and SCAD is life changing in many ways.

NOTE: Always consult your doctor if you are concerned about any new or ongoing symptoms.

 

Recuperating after SCAD

SCAD patients progress through recovery at their own rate and may have differing needs.

Attending cardiac rehabilitation sessions is highly recommended, if possible.  It is very common for a SCAD patient to lose confidence in their body, especially if they were feeling fit and healthy before their event – which most are.  Cardiac rehab helps to restore confidence whilst exercising in a safe environment and the rehab team will address any concerns.

Connecting with other SCAD patients can be a great source of information, support and encouragement.  In addition to the growing number of SCAD patients joining this portal, there are a number of on-line communities where SCAD patients from around the world share their experiences (for further details, see the Links section).

NOTE: Whilst sharing information, thoughts and opinions with other SCAD patients is a valuable experience, always remember that your body reacts in its own way and try to focus on your healing and progress.

 

This page is compiled by SCAD survivors based on their own experience. It is not intended to take the place of medical advice from a clinical professional, and if you are in any doubt about any aspect of your condition or treatment, you are recommended to consult your own doctor appropriately.

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