Because spontaneous coronary artery dissection reduces or stops blood supply to the heart muscle, symptoms of SCAD include angina (chest pain) without having a heart attack or angina with heart attack.
SCAD survivors report various cardiac symptoms, ranging from vague sensations to the full-on “Hollywood” heart attack.
Chest – discomfort or pain described as pressure, tightness, squeezing, or elephant on the chest.
Upper body – radiating discomfort or pain into the arms, upper back, neck, or jaw.
Lungs – shortness of breath ranging from trouble taking breaths to a smothering sensation.
Fatigue – extreme exhaustion, unrelated to activity or sleep quality
Sweating – unexplained cold, clammy perspiration
Nausea – ranging from indigestion to vomiting
Most SCAD patients experience heart attacks due to blocked arteries, but dissections may occur and not cause a heart attack. Depending on the percentage of blockage by a flap or blood clot, the heart muscle may not be damaged. Instead, the patient experiences what is called acute coronary syndrome (ACS). If the artery is severely blocked, the heart muscle becomes starved for blood and the muscle tissue begins to die. In this case, the patient is having a heart attack, which can be diagnosed by testing for elevated troponin enzyme levels in the blood and by confirming changes in electrocardiogram (ECG or EKG) readings.
Current research reports that more than 50% of SCADs are “ST Elevation myocardial infarctions,” the type of heart attack resulting in muscle damage. Nearly 25% of SCAD patients have multivessel dissections when diagnosed.
One of the most overlooked symptoms of SCAD? Death. It remains unknown how many people die of SCAD each year. Those who suffer cardiac arrest may not be identified as SCAD if the family does not request an autopsy. SCAD Alliance places great emphasis on education and awareness of SCAD in the medical community for this very reason. It is quite possible SCAD is an unrecognized subset of the 600,000 heart attack deaths each year in the U.S.
With increased awareness of SCAD among emergency medical professionals and more readily available Automatic External Defibrillators (AEDs), sudden cardiac arrest from SCAD can be caught in time.