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Spontaneous Coronary Artery Dissection (SCAD) is a tear in an artery’s inner lining, creating a blockage. SCAD is an under-recognized cause of acute coronary syndrome, heart attack and sudden cardiac arrest.
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The average age of SCAD survivors is 42. Nearly 80% percent of known SCAD patients are women, with 20 percent experiencing their dissection in the peripartum period, either late in pregnancy or in the weeks after having a baby. The remaining women appear to experience SCAD related to extreme exertion or associated conditions such as fibromuscular dysplasia (FMD) or connective tissue disorders, such as Marfan or Ehlers Danlos syndrome (Type IV). Hormone fluctuations also may play a role.
SCAD in men appears to be triggered by extreme physical exertion (e.g., fitness boot camps, triathlons) or the associated conditions as well. SCAD patients overall have none of the typical risk factors associated with other causes of heart attack, such as high blood pressure or plaque rupture from cholesterol buildup.
In addition to identifying SCAD’s associated conditions, early research has uncovered facts that prove the urgent need for targeted research and educating the medical community to take a closer look at younger patients exhibiting heart attack symptoms. Contrary to popular belief, SCAD survivors can experience additional dissections, ranging from days to a decade after the original event. Most subsequent SCADs occur in a different vessel. Second or third SCADs have been seen in arteries other than the coronaries, including the femoral and internal carotid arteries. The recurrence rate of SCAD is estimated to be 21%.
SCAD may occur when a combination of factors and conditions occurs as a “perfect storm.” Associated conditions of SCAD such as vascular irregularity, hormonal influences, collagen/genetic defect (e.g., Marfan, Ehlers Danlos, other connective tissue disorders), and physical exertion may interact or be subsets of each other.