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SCAD A Typical Heart Attack Striking Mostly Females

Imagine a young lady who was trying to juggle everything from work to home and she suddenly felt that she was going to pass out and had a heavy feeling in her chest and arms. She thought she might have an anxiety attack. The heavy feeling came back the next day. She knew something bad is happening and was sent to hospital. By the time she got there, she was in the middle of a heart attack and was admitted to the intensive care unit and had a second heart attack 2 days later. She was diagnosed with a type of heart attack known as spontaneous coronary artery dissection (SCAD), which is often found in younger women.

Unlike a more typical heart attack caused by a buildup of plaque in the arteries, a SCAD heart attack starts with a tear in an artery. The tear blocks the artery and blood flow to the heart, leading to a heart attack. While SCAD causes a small percentage of heart attacks overall, it is responsible for 40 percent of heart attacks in women under the age of 50. And it is mostly happening to young women: more than 90 percent of SCAD patients are female, and the average patient is 42 years old.

Between 10 and 15 percent of cases happen around childbirth. Though researchers have yet to find out a specific gender or hormonal explanation, they know that the physical strain of childbirth is not the main cause since SCAD happens with both C-sections and vaginal deliveries. It appears to be linked to other artery problems, most commonly fibromuscular dysplasia (FMD). This disease causes cells to grow abnormally in artery walls and is seen in at least half of SCAD patients. SCAD can run in families, too, though this has not been confirmed. Some studies have also pointed to a hormonal link, showing a greater incidence among postpartum women and women who are experiencing or close to a menstrual cycle.

Patients often do not know they have the disease until doctors look for artery abnormalities after a heart attack. Hence, it is now recommended that all SCAD patients be checked for FMD and other artery problems such as brain aneurysms or blockages or dissections or tears in other vessels. Survival rates are much better than originally thought. The death rate is actually very low, ranging between 1 and 5 percent. Outcomes are better than those with regular heart attack. Chances for a repeat SCAD are, however, greater, happening in more than 20 percent of cases.

Treatment methods used for standard heart attack might not suitable for patients of SCAD. Stents implantation to open blocked arteries for regular heart attack patients might make things worse for patients with SCAD because of the tears in arteries. Doctors often treat SCAD patients with a combination of aspirin and an anti-platelet medication. The patients are watched closely for early complications, and patients must do rehabilitation. Patients are given emotional support and education about heart health and exercise. Most patients get better in a matter of weeks, although depending on how quickly they were diagnosed, there may be lingering heart damage.

Victims of SCAD are often thin, appear heathy, and have no risk factors like smoking and diabetes. It is often misdiagnosed and may lead to treatment that can cause more artery damage. Many SCAD patients are even sent home from hospitals in the middle of a heart attack that is not discovered for days. Heart attacks are diagnosed with blood work and a test called an electrocardiogram, but SCAD can only be diagnosed with an angiogram.

Some patients recalled that they had extreme emotional or physical stress in the days before a SCAD, like a death in the family, breakdown in marriage, job stress, intense physical exercise and even lifting heavy items. As SCAD is difficult to diagnose before it causes a heart attack, recognizing the symptoms of a heart attack is so crucial for SCAD patients. Warning signs may include chest pain or pressure, shortness of breath, profuse sweating and dizziness.




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