When your artery tears – Spontaneous Coronary Artery Dissection

20 Dec

by Carolyn Thomas  @HeartSisters

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Laura, a 40-year old American heart attack survivor, told me this story of her own cardiac event:

“I was asleep and my symptoms woke me up. I had several simultaneous symptoms, but the first one seemed to be chest pain in the centre-left, somewhat under my left breast area. I’d never felt anything like it, so sometimes it’s hard to describe – it wasn’t sharp or crushing or burning, more like a dull pressure. I also had pain down the inside of my left arm that radiated up into the left side of my jaw and my left ear.

“I was very overheated, and I felt like I was going to throw up. The nausea and overheating faded, but the pain – chest, arm, jaw – stayed. In hospital, I was diagnosed with a heart attack caused by SCAD – spontaneous coronary artery dissection, treated with six stents.”

It used to be, and sadly remains in almost 70% of cases, a deadly condition often only correctly identified post-mortem during autopsy.  

This brief animation shows what happens during Spontaneous Coronary Artery Dissection - literally a tear in the wall of a coronary artery, or SCAD as we heart sisters know it.

In women, it’s usually the Left Anterior Descending coronary artery involved; in men, it’s typically the Right Main. The tear can either be ‘primary’, occurring spontaneously out of the blue, or ‘secondary’ as a consequence of undergoing coronary angiography, coronary intervention, cardiac surgery or chest trauma.

I like Laura’s simple yet comprehensive explanation of how SCAD usually happens:

“It’s like when the lining of your favorite coat tears, up near the shoulder, and you accidentally put your arm through the space between the torn lining and the outer layer of fabric, but since the sleeve and lining are still sewn together at the wrist, your arm can’t actually come out where it should, at the end of the sleeve.

“Your trapped arm is like the blood in a dissected coronary artery that can’t get to its destination”

Up to 80% of SCAD cases occur in young healthy women. According to a September 2010 study published online in the Journal of the American College of Cardiology:

“Patients diagnosed with SCAD are characterized by an absence of coronary risk factors, an association with physical or emotional stress, and a high incidence of infarction (heart attack)” .

Spontaneous Coronary Artery Dissection (SCAD) that caused Laura’s heart attack is sometimes referred to as “rare”, but Mayo Clinic cardiologist Dr. Sharonne Hayes now describes this condition as “underdiagnosed” or “infrequent”, especially when discussing heart attacks in younger women. (Mayo Clinic recently saw three SCAD cases in one day, one acute and two as outpatient consultations).

♥   Have you been diagnosed with Spontaneous Coronary Artery DissectionFind out if you are eligible to participate in two new SCAD studies at Mayo Clinic.

  Learn more:

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    This article ranked #8 on the Top 10 Most Popular Posts here on Heart Sisters for 2013.

13 Responses to “When your artery tears – Spontaneous Coronary Artery Dissection”

  1. Beth Holland June 26, 2014 at 10:56 am #

    I had an appointment with my Cardiologist 2 days ago and I took him readings from my Blood pressure and my heart rate for two weeks prior to the appointment. (Some readings 203/90, 186/80, 195/90, 198/95, all taken Fri. 13, 2014). I WAS IN THE HOSPITAL 5 WEEKS AGO FOR SEVERAL DAYS WITH HIGH BLOOD PRESSURE THEN. He increased my Blood Pressure med. again but I felt he shrugged off the possibility of SCAD, saying he was not familiar with SCAD. My doctor has me scheduled for an ECHOCARDIOGRAM in two weeks after I take this extra BP med & see what it does and after that I am scheduled for a Nuclear Stress the next week. I am scared and don’t know where to turn. Do you have any advice for a very suspicious patient?

    Like

    • Carolyn Thomas June 26, 2014 at 1:14 pm #

      Hi Beth – I’m not a physician so of course cannot offer you advice on your specific case. However, I can tell you that generally SCAD patients have few if any of the typical risk factors associated with other causes of heart attack such as high blood pressure. Sounds like your docs have organized further diagnostic testing, which is good. Meanwhile, I hope that your new meds are helping address your BP numbers.

      Like

  2. annette lacelle October 1, 2012 at 11:59 pm #

    i was diagnosed with SCAD one month ago after having a heart attack and feel lucky and scared

    Like

    • Carolyn Thomas October 2, 2012 at 7:32 pm #

      Hello Annette and welcome to the very exclusive club that nobody ever wants to join. You are in very early days yet so no wonder you are feeling conflicting emotions. If you haven’t done so already, please visit the WomenHeart online community of SCAD patients – it’s free to become a member and you’ll find many other women just like you there.

      Like

  3. LaShalle Barrow April 17, 2012 at 11:00 am #

    My 14 year old daughter suffered a heart attack on March 20, 2012 that was caused by SCAD. I’m from a big city and the doctors had never heard of this happening to a young child. I’m trying to gain enough information about SCAD for my daughter. I thank GOD that he saved my daughter and you as well. I really enjoyed this website.

    Like

    • Carolyn Thomas April 17, 2012 at 9:05 pm #

      Lashalle, what a nightmare! And at such a young age – no wonder your doctors had never encountered a case like this. I hope your daughter is doing much better day by day as you and your family try to make sense out of a diagnosis that makes no sense to us! Good luck to all of you.

      Like

  4. Laura September 6, 2011 at 7:56 pm #

    Thanks again to my heart-sister Carolyn for covering this story.

    I cringed when another friend referred to my “15 minutes of fame.” I quickly corrected her. This isn’t *my*15 minutes of fame, it’s SCAD’s 15 minutes of fame.

    For every woman out there who’s scared, newly diagnosed, just out of the hospital, and told that what happened to her was rare and we don’t know anything about it, all of this publicity and research is hopefully leading toward the point sometime in the future where cardiologists won’t shrug and say “We have no idea” when confronted with a SCAD.

    There’s a vibrant, active group of us SCAD survivors on WomenHeart’s online message forum, here; please join us.

    For as we’ve seen, when we come together for a common goal, we can do it!

    Like

    • Carolyn Thomas September 6, 2011 at 8:14 pm #

      Thanks Laura for this link to the WomenHeart forum. I think the specific topic you started there about SCAD, however, is an absolute goldmine for SCAD survivors and their physicians.

      In fact, after hearing about SCAD experiences for the past few years from you and other survivors, I was almost surprised to learn how “rare” the diagnosis is considered. It may well be rare to physicians who rarely recognize it when (young, healthy) women show up in the E.R., but to those of us who share stories with other heart patients every day like this, we can feel like it’s tragically common.

      Your efforts with Katherine to spur this Mayo Clinic SCAD research is such a great example of what women can do when they put their mind to it.

      I hope every single SCAD survivor will contact Mayo Clinic to participate in this study.

      Cheers,
      C.

      Like

  5. U.K. Lass September 2, 2011 at 4:12 pm #

    I’d barely heard of SCAD until I read about it here – and yet this week it seems I’ve heard the Mayo Clinic SCAD research project talked about everywhere! It’s about time that more attention and awareness was raised about this deadly and predominantly female diagnosis. Thank you very much for this.

    Like

  6. Lisee B. September 2, 2011 at 10:30 am #

    Just found this article while trying to learn more of the new Mayo Clinic research on SCAD. This is such an impressive website for women heart patients (and men, too!!!) I can’t believe how much really good stuff you have here, told as only an actual heart attack survivor can tell it. Easy to read, well-written, evidence references, just great stuff! Please keep up the good work – I’m a brand new subscriber now.
    Lisee in Montreal

    Like

  7. Kim February 9, 2011 at 8:58 am #

    Nobody in our whole family had ever even heard of this condition until my twin sister age 42 was hospitalized for a heart attack caused by SCAD. Our mid-sized hospital had never actually seen this in a living patient – usually diagnosed on autopsy, they said. She is very lucky to have survived, as I’m learning from your wonderful website and the very few other resources that even mention SCAD.

    THANK YOU THANK YOU for this and for the link to the SCAD website.
    With gratitude,
    Kim

    Like

  8. Jane's Sis January 8, 2011 at 1:02 pm #

    My sister is in hospital right now after a heart attack diagnosed with SCAD. Your post here is perfect timing. Our whole family is reeling from this she is only 35 too young for heart attack. Thx VERY MUCH for this.

    Like

    • Leann January 18, 2011 at 2:59 pm #

      Best wishes for your sister’s full recovery. I wish you all much strength and courage.

      I experienced SCAD three years ago (45). SOOO scary! The LAD artery continued to dissect, so I had three “events” in the stretch of a little over a week…I now have 7 stents.

      I wasn’t feeling very powerful after that, but the thing that made me feel powerful was to learn all I could about this. I feel so fortunate that I have been given a second “birthday” to celebrate!

      Stay strong!

      Like

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