Friday, February 5, 2016

What to know about SCAD

REHAB ROUTINE: Gervino with Nancy McCleary, RN, cardiac rehabilitation nurse at the MGH

“Thin, fit and athletic.”

It’s not a typical portrait of a heart attack patient – but it’s how Malissa Wood, MD, co-director of the Corrigan Women’s Heart Health Program, describes dozens of her female patients in the last two years. All of them have experienced spontaneous coronary artery dissection (SCAD), something Wood says is an underdiagnosed cause of heart attacks today.

Before her SCAD last September, 36-year-old Lindsay Gervino exercised five days a week while also running after two small children. It was during a workout at home that Gervino felt a tightness in her chest, nauseated and lightheaded. Responding EMTs performed an electrocardiogram. The indication of a heart attack, says Gervino, left her and her husband “staring at each other in disbelief.”

A buildup of plaque is often at the root of most heart attacks. SCAD occurs when a tear forms in one of the three layers of an artery wall, blocking blood flow in the heart. That blockage can cause a heart attack, heart failure or even death. The causes of SCAD are not fully known, but may be genetic or related to hormone and blood vessel changes during pregnancy. The MGH currently is one of only a few hospitals in the nation researching SCAD and is the only site in New England caring for SCAD patients.

Gervino was referred to Wood after receiving initial care at her local hospital. Now, she is taking blood thinners to keep blood flowing to her heart. She also has enrolled in a cardiac rehabilitation program through the MGH Cardiovascular Disease Prevention Center, getting back to the treadmill and light weight training and learning how to better manage stress.

“Many times a SCAD tear will heal on its own and doesn’t require surgery or a stent,” says Wood. But, she adds, the key to surviving SCAD is for women to recognize the symptoms of a heart attack and quickly call 911. “My mantra to all women is if they feel new or different symptoms, like chest pressure or tightness, have it checked out.”

Heart attack symptoms in women

Pain, heaviness or pressurein the chest are often the hallmark symptoms of heart attacks in men. 

According to physicians at the Corrigan Minehan Heart Center, women may exhibit very different symptoms and should watch for:

  • Pain in the jaw, neck, arm or back

    A feeling of indigestion

    Shortness of breath

    Nausea or vomiting


    Lightheadedness or dizziness

    Extreme fatigue

If you or someone you know exhibits any of the above warning signs, act immediately and call 911.


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