ROCHESTER, Minn. -- Patients who suffer from a type of heart attack that affects mainly younger women, called spontaneous coronary artery dissection or SCAD, may benefit most from conservative treatment, letting the body heal on its own. This is according to a new scientific statement by a Mayo Clinic led team, published by the American Heart Association in its journal, Circulation.
Most heart attacks occur when plaque builds up in arteries over a lifetime. The plaque ruptures, causing a blockage and a heart attack. In SCAD, a tear occurs inside an artery, and that can cause a blockage, leading to a heart attack.
"It may seem counterintuitive, but we discovered that treating SCAD the same way we treat heart attacks due to atherosclerosis can cause further tearing and damage to the vessel," says Sharonne Hayes, M.D., chair of the writing group for the new scientific statement and a Mayo Clinic cardiologist who founded its Women's Heart Clinic. "But the initial proper diagnosis is critical in guiding the care."
The statement is an overview of what an international group of experts know about SCAD, including:
-- Its high rate of post SCAD chest pain and recurrence
-- Its association with women, pregnancy, and physical and emotional stress triggers
-- Its connection to other diseases of the arteries, such as fibromuscular dysplasia
-- The best diagnosis and treatment recommendations based on new evidence and experts' care of SCAD patients.
Until 2010, little was understood about SCAD, which had been described as a rare and universally fatal cause of acute coronary syndrome, heart attack and sudden cardiac arrest in women during and shortly after pregnancy.