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The comprehensive care of the post-SCAD patient
Madeline Zipperer1, Juan Enciso2, Malissa Wood3
1University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Insights
Spontaneous coronary artery dissection (SCAD) is a key cause of acute coronary syndrome in young women. This review consolidates knowledge on SCAD management, covering medical care, rehabilitation, and mental health for survivors.
Area of Science:
- Cardiology
- Vascular Biology
- Women's Health
Background:
- Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic cause of acute coronary syndrome (ACS).
- SCAD predominantly affects young women, and its prevalence may be underestimated due to underdiagnosis.
- The pathogenesis is multifactorial, involving hormonal, genetic, and stress-related factors.
Purpose of the Study:
- To review current knowledge on spontaneous coronary artery dissection (SCAD).
- To consolidate information on medical management, rehabilitation, and specialized care for SCAD survivors.
- To highlight the need for comprehensive guidance addressing SCAD's multifaceted nature.
Main Methods:
- Literature review of existing studies on spontaneous coronary artery dissection (SCAD).
- Synthesis of information regarding SCAD pathogenesis, clinical presentation, and management strategies.
- Identification of gaps in current guidance for post-SCAD patient care.
Main Results:
- SCAD is an increasingly recognized cause of ACS, particularly in young women.
- Pathogenesis involves a complex interplay of factors including hormonal changes, genetics, and stressors.
- Current clinical guidance for post-SCAD patients remains limited.
Conclusions:
- Comprehensive understanding and management of SCAD require addressing its diverse contributing factors.
- Improved outcomes and quality of life for SCAD survivors necessitate integrated care approaches.
- Further research and guideline development are crucial for optimizing SCAD patient care.
Abstract:
Spontaneous coronary artery dissection (SCAD) is the nonatherosclerotic, nontraumatic dissection of an epicardial coronary artery which is predominantly caused by intramural hematoma formation or intimal disruption. SCAD is an increasingly recognized cause of acute coronary syndrome (ACS) in young women and its true prevalence may be underestimated due to its underdiagnosis. The pathogenesis of SCAD is multifaceted and influenced by gender-specific factors, hormonal fluctuations, genetics, arteriopathies, and physical and emotional stressors. Although the pathogenesis of SCAD is multifaceted, current guidance on the care of the post-SCAD patient is limited. Moreover, it is necessary to address each of the different components contributing to the pathogenesis of SCAD in order to improve outcomes and quality of life in this patient population. This literature review aims to consolidate the current knowledge on the medical management, rehabilitation, reproductive and mental health care, and comorbidities that affect SCAD survivors.
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