Spontaneous Coronary Artery Dissection
(SCAD)
Treatment
While there’s no definitive drug treatment for spontaneous coronary artery dissection (SCAD), many patients will be prescribed long-term aspirin and a combination of other medications—with beta blockers being the mainstay of treatment, which decrease the heart rate and force of blood pumped from the heart to lower blood pressure. In some SCAD cases, surgery may be the only option for treatment.
Medications
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Blood pressure medications - Beta-blockers and antiplatelet drugs such as aspirin with clopidogrel reduce internal pressure on the blood vessels. ACE inhibitors may be used to lower blood pressure further if there has been damage to the heart muscle. Discontinue hormone therapy such as estrogens and progesterone.
Surgery
In more severe cases of SCAD with ongoing symptoms, treatment may involve the following procedures:
- Coronary artery bypass surgery – Also known as open-heart surgery, this invasive procedure reroutes blood flow to the heart.
- Coronary stenting – This procedure involves placing a scaffold in the blood vessel to keep it open. Because it’s less invasive than coronary artery bypass surgery, coronary stenting is usually the preferred revascularization strategy when feasible.
If you’ve had a spontaneous coronary artery dissection (SCAD) in the past, you’re at risk of reoccurrence. If you’ve had any recent changes in your health, let your doctor know, but also make sure that you’re doing what you can to reduce your risk for cardiovascular disease in general.
- Eat a healthy diet – A heart-healthy diet is rich in lean meats, fruits, vegetables, and whole grains and is limited in salt and solid fats. Your doctor may suggest working with a dietician or nutritionist to develop an eating plan.
- Exercise regularly – Getting regular exercise is one of the keys to a healthy heart. Most doctors recommend incorporating more movement into daily life, such as taking the stairs rather than an elevator or escalator. Avoid strenuous exercise, competitive sports, or lifting weights > 50 lbs. Be sure to check with your doctor before embarking on any exercise plan.
- Quit smoking – Tobacco use is one of the leading causes of heart health problems. If you don’t smoke, don’t start. If you do smoke, now’s the time to quit. Your doctor is a great resource you can use to help you succeed.
- Watch your alcohol – Too much alcohol can spell trouble for the heart, particularly when used excessively. If you must drink alcohol, limit your intake to no more than one drink (equal to 1.5 ounces of liquor, 5 ounces of wine, or 12 ounces of beer) per day for women* and two drinks per day for men*.1
- Visit your doctor regularly – Since there’s some risk of reoccurrence after SCAD, most patients will be followed by a cardiologist long-term. Make sure you make regular appointments, as this will help your cardiologist gain the best understanding of your current health status.
*The term “women” in the context of “women’s cardiovascular health” applies to individuals assigned female at birth (AFAB) who have a female biological reproductive system, which includes a vagina, uterus, ovaries, Fallopian tubes, accessory glands, and external genital organs.
*The term “men” in the context of “cardiovascular health” applies to individuals assigned male at birth (AMAB) who have a male biological reproductive system, which includes a penis, scrotum, testes, epididymis, vas deferens, prostate, and seminal vesicles.