Image of a normal heart.
Image of a heart with hypertrophic cardiomyopathy.
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The coronary arteries are the vessels that supply blood and oxygen to your heart muscle. A tear or dissection that forms in the vessel wall causes SCAD.
When a tear causes the inner layers of the artery to separate from the outer layers, blood can pool between the layers. This pool of blood outside the blood vessels is a hematoma.
As the hematoma gets larger, it can block normal blood flow to the coronary arteries and cause symptoms of a heart attack.
SCAD is an emergency condition that requires immediate diagnosis and treatment.
While most people aren't at risk of SCAD, it's the most common cause of heart attack in women in their 40s-50s.
Researchers don't know exactly how many women have the condition because of underdiagnosis in the past.
Now, more women are receiving a diagnosis due to advances in testing for SCAD.
Hospitals also have registries to increase both doctor and patient awareness and to learn more about the disease. Ask your doctor about these registries to help you connect with others who have SCAD.
Because the blood pools and can clot within the vessel wall, SCAD reduces or blocks blood flow to the heart.
This can lead to:
Doctors and researchers haven't learned the exact cause of SCAD. Many women with SCAD don't have common risk factors for heart disease, such as high cholesterol or diabetes.
But they have found some factors that increase your risk:
At the Magee-Women's Heart Program, we:
SCAD causes heart attack symptoms. Women who have these symptoms should seek care right away, even if they don't have heart attack risk factors.
Symptoms include one or many of the following:
To diagnose SCAD, your doctor uses imaging tests similar to diagnosing other types of heart attacks.
The goal of SCAD treatment is to make sure there's constant normal blood flow to the heart.
If you have heart attack symptoms, go to the ER right away.
You may need to stay in the hospital. This is so we can give you medicine to help ease your symptoms and observe you for complications of SCAD.
The blood clot will often heal without surgery or further invasive treatments.
After diagnosis, your doctor will decide the best SCAD treatment for you.
Your doctor may prescribe drugs to treat SCAD or control symptoms, such as:
Your doctor may want to place a stent if SCAD severely impedes blood flow or if drugs don't control your symptoms.
The stent is a small mesh tube that lets blood flow through the artery normally.
This treatment is much like a coronary angiogram that diagnoses SCAD. Your doctor inserts a catheter through an artery in your wrist or leg to place a stent in the coronary artery.
This surgery uses a blood vessel from another part of the body to divert blood away from the damaged vessel.
You may need this surgery if your doctor:
After diagnosis and treatment, you may spend a few days in the hospital. This is to make sure the vessel tear doesn't get worse and cause complications.
You can expect a longer stay if you need a stent or bypass surgery.
Your doctor may prescribe cardiac rehab after you leave the hospital. This supervised exercise helps you feel safe and build strength to get back to your normal activity.
SCAD can happen again, particularly after childbirth or when entering menopause.
At Magee-Women's Heart Program, our experts work closely with specialized obstetricians to take care of you before, during, and after pregnancy.