13. Creating a “New Normal”

After a SCAD, returning to “normal” may seem impossible. In fact, many patients prefer to think about this as creating a “new normal”. Life will never be exactly what it was before your cardiac event. You may be changed in many ways, including:


SCAD is a biological process and either the cardiac event or the treatment you received may have caused you to experience new physical symptoms including pain, cardiac sensations, and physical fatigue. Understanding SCAD, making time to care for your physical health, communicating effectively with healthcare providers are all part of the “new normal.”


Any major medical event requires some amount of psychological adjustment. Optimal management and prevention of SCAD is not well understood and this uncertainty introduces additional psychological strain. Common psychological symptoms after SCAD include anxiety, depression, and a reduced sense of safety and control. Actively managing stress is an important part of the “new normal.”


Having a heart attack is a challenge for anyone, and may be particularly challenging for women. It can affect how we view ourselves and how others view us. These shifts can impact interpersonal relationships and, importantly, social support networks. Actively re-engaging with friends and family and creating new support networks is critical for healthy adjustment to SCAD.


Many patients revisit their spiritual beliefs after SCAD. Some begin to think more about mortality and have an increasing concern with existential issues and the meaning of life. Although this is always difficult, it it also an opportunity to re-evaluate what matters most and bring our energy in line with our values. Meeting with a spiritual counselor, therapist, religious leader, or trusted friend can be extremely helpful in navigating this process.

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