The Unique Needs and Challenges of Young Females After Spontaneous Coronary Artery Dissection
Kathleen Lalande1, Karen Bouchard, Thais Coutinho
1Author Affiliations: University of Ottawa Heart Institute, Ottawa, Ontario, Canada (Drs Lalande, Bouchard, Coutinho, Reed, and So, Ms Chiarelli, Drs Wells, and Tulloch); University of Ottawa, Ottawa, Ontario, Canada (Drs Bouchard, Coutinho, Reed, and So, Ms Chiarelli, Drs Wells, and Tulloch); Division of Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada (Dr Mulvagh); Department of Cardiology, University of Montréal Hospital Centre, Montréal, Quebec, Canada (Dr Pacheco); Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Dr Liu); Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada (Dr Saw); and Patient Partner, University of Ottawa Heart Institute, Ottawa, Ontario, Canada (Mss Robert and Lappa).
Purpose:
Spontaneous coronary artery dissection (SCAD) disproportionately affects females who are often younger in age. Age-based comparisons of the post-SCAD experience are required to adequately inform rehabilitation programming that is sensitive to patient life circumstances and needs. This multi-site qualitative study investigated the experiences of SCAD in females analyzed according to their age (<50 and ≥50 years).
Methods:
Females who had experienced a SCAD event were recruited from 5 large tertiary care hospitals. Participants completed sociodemographic and medical questionnaires and took part in a semi-structured interview. Transcribed data were subject to the framework method using deductive coding. Constructed codes and overarching themes were then compared in the <50 and ≥50-year patient groups. Themes that highlighted the central differences between demographic groups were then constructed inductively.
Results:
Overall, females with SCAD (n = 77; mean age = 52.9 ± 10.8 years; range = 29-77) reported struggling with a lack of information from their health care team with regards to the diagnosis, management, and long-term prognosis of SCAD. Younger patient (n = 32; mean age = 40.2 ± 6.7 years) transcripts evidenced more prominent themes of uncertainty, dissatisfaction with cardiac rehabilitation programming, difficulty adjusting to lifestyle and vocational changes, and family-related distress in comparison to those over 50 (n = 45; mean age = 57.8 ± 6.9 years).
Conclusions:
Females with SCAD who are <50 years old appear to experience their recovery from SCAD differently than those who are older in age. These differences suggest that tailored approaches may be required in cardiovascular rehabilitation programming for younger SCAD patients.
