Not all heart attacks are the same, based on a recent statement from the American Heart Association, which highlights a lesser-known cause of heart events called spontaneous coronary artery dissection.
Published in the American Heart Association Journal, Circulation, this statement addressed spontaneous coronary artery dissection, often referred to as SCAD. SCAD is a serious condition that occurs when there’s a tear in one of the heart’s blood vessels. Similar to plaque build-up in the arteries, the tear can slow or block blood flow to the heart, potentially causing heart attack or sudden death. However, heart events caused by SCAD are very different from typical heart attacks and pose unique challenges, according to experts.
One of the challenges, according to experts, is that we don’t know just how common SCAD really is. That’s mainly because SCAD tends to occur in young, healthy patients—many of which have no risk factors for heart disease. So while they experience typical symptoms of heart attack, many are misdiagnosed or simply discharged due to their low cardiovascular risk.
Evidence suggests that SCAD causes anywhere from 1–4% of heart attacks, but rates could be even higher.
Another important point, according to authors, is that SCAD appears to be more common in women. Evidence suggests that SCAD causes more than one-third of heart attacks in women 50 and older. It’s also the most common cause of heart attacks during pregnancy, accounting for 43% of pregnancy-related heart attacks.
Since SCAD is so common in women, it’s important that women are able to recognize symptoms and seek immediate treatment. Symptoms of SCAD are the same as other types of heart attacks and include chest pain; rapid heartbeat; pain in the arms, shoulders or jaw; shortness of breath; sweating; fatigue; nausea and dizziness.
Lastly, experts note that SCAD is unique because it tends to be brought on by physical and emotional stress. Evidence suggests that emotional triggers are more common in women, while physical triggers like weight lifting or intense exercise are more common in men. Thus, it’s important that providers test for SCAD when patients have concerning symptoms that may have been triggered by stress.
Ultimately, experts hope their recent statement helps raise awareness for SCAD and increases both diagnosis and treatment. Authors also applaud the efforts of SCAD survivors, who have sparked much-needed research on the issue. Finally, they strongly encourage future research on the issue, noting that the statement is a "call to action among the medical and patient communities."