Is SCAD Heart Disease

[Marie3811]

Hi All

I hope you are all doing well

Is Scad considered heart disease?

Thanks

[Marie3811]

Spontaneous Cononary Artery Dissection

[JoanyB]

TRST - SCAD is Spontaneous Coronary Artery Dissection, which usually (but not always) causes heart attacks, and mainly in women.

Hi Marie! It is a tricky one, and no, I understand it's not heart disease as such, in that we don't have plaque build-up etc. The vast majority of sufferers only have one SCAD in a lifetime so you could say it's just an 'event' rather than a disease. I am not even sure that if you have been left with a small amount of damage to your heart (some have none, some unfortunately have severe damage) that that counts as disease either.

Have you had any tests such as CT angiogram or MRI to see if your dissection has healed?

Only my opinion as a non-medic of course. I could ask on the SCAD support group Facebook page for the thoughts of those on there if you want?

[Marie3811 in reply to JoanyB]

Hi JoanyB thanks for your very helpful response I do have scans and I have regular check ups with cardiologist and take meds daily. If you could ask the group please that would be very helpful Many thanks I think they do need to provide further guidance as this is different and rare form of a heart attack Best wishes

[Milkfairy Heart Star in reply to Marie3811]

Hi Marie3811

Joanny B as ever had given great advice.

SCAD would be described as a type of non obstructive coronary artery disease.

I live with another type coronary vasospastic angina.

Here's a link to the Canadian Heart and stroke association about SCAD. It describes SCAD as a type of heart disease

heartandstroke.ca/heart/con...

[JulianM]

There's a great UK support group called Beat SCAD, which publishes awareness materials and has a really helpful website: it's at beatscad.org.uk

I coach swimmers, and one of my adult male swimmers suffered a SCAD during one of my sessions. The diagnosis was difficult for the paramedics and hospital doctors - these events are rarer than standard heart attacks, don't present in quite the same way, and he was very lucky to get first rate treatment (emergency surgery with bypass grafting) at Bart's that night. He's been back swimming and is doing well, but it's a challenge.

Blood pressure control needs to be very rigorous after the event, so I would say yes, it is a form of heart disease, although the risk factors are entirely different to the more common cardiovascular disease that accounts for most heart attacks and strokes.

[Marie3811 in reply to JulianM]

Thanks you so much for your message it’s appreciated and so so sorry to hear about your friend and glad he has returned to what he enjoys I am on heart medication and blood pressure best wishes

[Sunnie2day]

I don't have SCAD, I have other heart conditions (all mild-ish and well controlled by medication and lifestyle). My cardiologist did think I had heart disease until my angiogram and right heart study last November showed 'crystal clear' arteries. Now he says I have heart 'conditions' rather than heart 'disease'.

[Marie3811 in reply to Sunnie2day]

Thanks so much sharing very helpful

[Henry20]

Just like to point out that SCAD does have an alternate medical meaning.

Short-chain acyl-CoA dehydrogenase (SCAD) deficiency is a condition that prevents the body from converting certain fats into energy, especially during periods without food (fasting).

It is very rare and is inherited. Most doctors don't even know the disease exists, it was only identified in 1987. The more who know about it the better, which is why I am mentioning it here. It can be extremely serious or very mild, but people with it need to shield. If young children fail to thrive and go all floppy, it needs to be looked for, but you need to know to look. However, in some, it might not put in appearance until adulthood.

Henry

[JoanyB in reply to Henry20]

Just goes to show the dangers of acronyms! I did know what Marie was referring to in this case as we have chatted before!

Interesting about the 'other' SCAD though.

[Marie3811 in reply to Henry20]

Thanks you so much Henry this really helpful

[JoanyB]

Marie, I have asked the question on the support group Facebook page. The above posts show how complicated it is!!

I look at my SCADs like a broken leg. Yes, a couple of arteries 'broke' but they healed and as my arteries are clear I don't consider myself to have a disease.

Some people do have chest pains afterwards, but this is thought to be the heart healing and usually goes away after a few months I believe, so still not a disease.

I do take BP meds but I've been taking those for 20 years anyway, plus as advised my one of the SCAD experts as Leicester's Glenfield Hospital, I have also stayed on a low dose beta blocker to help with the BP (which is well controlled). She also took me off aspirin after the various tests came back OK.

[Milkfairy Heart Star in reply to JoanyB]

It is complicated. It depends largely on your view point.

There are so many different definitions . Here's just one!

'An abnormal condition of a part, organ, or system of an organism resulting from various causes, such as infection, inflammation, environmental factors, or genetic defect, and characterized by an identifiable group of signs, symptoms, or both.'

ncbi.nlm.nih.gov/pmc/articl...

[JoanyB in reply to Milkfairy]

In that case I guess SCAD is a disease!!!

And by the way, the Canadian document suggests that a repeat angiogram after 4-6 weeks may be necessary to see what is going on. This is NOT advised here in that it could cause further damage to what might be a delicate artery. MRIs or CT angiograms are fine.

I hadn't been told my first event was a SCAD so had done no research at all. If I had I would have been able to refuse one after my second as it was less severe and I was stable (indeed I had to wait 4 days in hospital feeling perfectly fine until they found me a cath lab spot!)

[Milkfairy Heart Star in reply to JoanyB]

I noticed the reference to the second angiogram too. Thanks for highlighting the different best practice here in the UK.

Otherwise the article did discuss the possible underlying causes in particular Fibromuscular dysplasia and connective tissue disorders.

Unfortunately some women here in the UK are still having angiograms and stents inserted to treat their SCAD.

It does show how long it can take to get research translated into Clinical practice about how SCAD should be managed.

The UK is fortunate to have Dr David Adlam and his Leicester team's research showing that a ' conservative' approach to managing SCAD is usually the best approach.

[Marie3811 in reply to Milkfairy]

Very complicated many thanks for sharing

[Marie3811 in reply to JoanyB]

Thanks so much for sharing

[Milkfairy Heart Star]

Hi Maire,

just out of interest why have you asked whether SCAD is a disease?

[Marie3811 in reply to Milkfairy]

Hi milkfairy I was about to fill out a questionnaire and wasn’t sure whether it was a disease or not! Many thanks

[JoanyB]

Hello Marie. I have been waiting to see how many replies I got to my my(your!) query on the Facebook page before replying.

No clear consensus I'm afraid. Some say disease, some uncommon condition, some rare disorder! One person likens it to "having a puncture...... Nothing wrong with the engine.”!

Here are some extracts of posts by one of the BeatScad Trustees:-

“With regards to where SCAD gets put on a website dealing with heart disease, this is a problem of classification more than definition. You've got to file 'SCAD' somewhere .... “

“Some of us may also have (or go on to have) 'traditional' heart disease, particularly after menopause, but early research findings suggest that genetic factors that might make someone more likely to have a SCAD also make us less likely to develop traditional heart disease. I and many others were told our arteries are 'clean as whistles' when we had our angiograms to diagnose our heart attack...”

Also at present there is no hospital admissions code so SCAD gets lumped in with the heart attacks that ARE caused by disease.

Sorry but there doesn't seem to be a clear answer!

[Marie3811 in reply to JoanyB]

Thanks so much for taking the time to help me with this it’s appreciated very complicated