Shortly after having her second child, Kristen Bowlds had a heart attack. She was stunned and soon learned that something called spontaneous coronary artery dissection, or SCAD, was the cause.
“I'm like, 'I have never heard of this before,'” she told TODAY. “I am 29 years old. I was healthy. I've never had any family history of heart disease ... and so I reacted like, 'How is this happening?’”
The ordeal wasn’t over. Two years later, SCAD struck again and she experienced a second heart attack, which led to emergency triple bypass surgery.
What is SCAD?
SCAD occurs when the layers of the coronary artery separate and blood becomes trapped in between. The wall layers then peel and bulge, which can lead to a blockage -- and this causes a heart attack.
Although some forms of heart disease affect older people more, SCAD is a rare form that often occurs in young, healthy people who may not suspect any problem.
Experts remain unsure what causes SCAD, but they know who is at greater risk:
- Healthy women between 30 to 50
- Women who recently gave birth
- People with connective tissues diseases, such as Marfan and Ehlers-Danlos syndromes
While both men and women experience SCAD, women are more likely to have it.
“About 10 to 20 percent of the cases of SCAD happened in women in the peripartum period — so either during or after pregnancy,” Dr. Jennifer Haythe, an associate professor of medicine at Columbia University Medical Center, told TODAY. “It's thought to really be related somehow to turbulent blood flow ... during labor where you increase your pressure.”
Treatment for SCAD
Because SCAD causes the tear, or dissection, of the artery, some of the usual interventions for artery problems, like catheters and stents, are more difficult to use because they can make the tear more severe. Doctors sometimes use them in combination with other therapies.
“Most women are treated with a combination of aspirin, beta blockers and anti-coagulant, like Plavix, and then sometimes a statin, depending on their cholesterol,” Haythe explained.
There is no cure for SCAD, but monitoring, certain lifestyle changes and rehab can help.
Experts recommend heart healthy eating habits — such as a low-fat diet, cardiovascular exercise and not smoking. Tailored exercise plans that put less stress on the heart can also help people with SCAD.
“It may benefit them to be in a special rehabilitation for people who have SCAD because there are less likely to be told increase their heart rate as much,” Haythe said.
Once a person experiences SCAD once, it’s more likely to happen again, so continued monitoring through periodic CT scans to look for weakened arteries is often recommended.
One of the most effective ways to monitor for SCAD is for women to be mindful of their own heart health, which Haythe said she sees happening more.
“Slowly women are starting to change how they view heart attack,” she said, “as less of a man's disease.
Watching for the signs of heart attack
Most people who have SCAD only become aware of it after they’ve already had a heart attack. That’s why knowing the symptoms of heart attack and seeking help immediately are essential.
“It's just even more of a reason to know the signs of a heart attack or so that they don't ignore it —especially in that particular age group where they're young and they're probably less likely to seek medical attention unless they really are having crushing chest pain,” Haythe said.
While chest pain is the number one symptom for both men and women, women tend to experience:
- Nausea
- Shortness of breath
- Dizziness
- Gastric discomfort
“All of those things are the symptoms that women should take seriously,” Haythe said. “The sooner you get medical therapy the better.”
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