From Challenges to Solutions: Patient Insights Inform Psychological Intervention Design After Spontaneous Coronary...

Spontaneous coronary artery dissection (SCAD) is a cause of acute coronary syndrome, primarily affecting women. SCAD is associated with elevated psychological distress and cardiac rehabilitation programs rarely meet these patients' mental health needs. Although the challenges faced by SCAD survivors are well documented, evidence on how patients want them to be addressed remains limited.

This study aimed to examine psychological intervention preferences among SCAD survivors, including potential sex differences.

Patients diagnosed with SCAD within the past 3 years were recruited from 6 Canadian hospitals. Participants completed questionnaires assessing sociodemographic and clinical characteristics, and rated their interest in intervention content and delivery methods using a 5-point Likert scale. Descriptive statistics were calculated and sex differences were analyzed using t-tests.

Among 326 participants (92.9% female; mean age 53.3 ± 11.1 years) top-rated intervention components included stress management (3.7 ± 1.2; 64.5% rated very/extremely interested), relaxation techniques (3.5 ± 1.2; 55.4%), cognitive behavioral strategies (3.5 ± 1.3; 56.8%), and processing the SCAD-related trauma (3.4 ± 1.4; 53.5%). Patients preferred SCAD-specific programming (3.9 ± 1.1; 70.8%) delivered by health care professional (3.4 ± 1.3; 56.2%) offered within 1 to 3 months postevent (3.5 ± 1.4; 61.8%). Women expressed greater interest than men in topics such as health advocacy and communication with children (all P < 0.05). Many women (55.1%) also conveyed high interest in gender-specific interventions.

SCAD survivors prefer early, individualized, SCAD- and gender-specific interventions focusing on cognitive, emotional, and trauma processing, delivered by health care professionals. Psychological interventions targeting these elements need to be developed and tested for SCAD survivors.