Heart attacks are often associated with older age, high cholesterol, diabetes, high blood pressure and smoking. But heart-related emergencies can also affect young and otherwise healthy women who may not have the usual risk factors. One such condition is Spontaneous Coronary Artery Dissection (SCAD), a less commonly recognised cause of heart attack. In SCAD, a tear or sudden injury develops in the inner wall of a coronary artery. Blood can then collect between the layers of the artery wall, narrowing or blocking the flow of blood to the heart.
Difference Between SCAD And A Typical Heart Attack
In a conventional heart attack, a buildup of cholesterol or plaque inside a coronary artery can rupture and trigger the formation of a blood clot, blocking blood flow. SCAD works differently. Instead of a plaque-related blockage, the layers of the artery wall separate following an injury or disruption within the artery. The resulting blood collection can compress the artery and restrict blood flow to the heart. According to experts cited in the original ABP News report, this means SCAD can occur even without longstanding cholesterol buildup in the artery.
SCAD Is More Commonly Seen In Women
SCAD is reported predominantly in women, particularly younger and middle-aged women. According to Dr Ambuj Roy, a cardiology expert and professor at AIIMS Delhi, around 80-90% of SCAD cases occur in women. SCAD may account for some heart attacks occurring in women below the age of 50. Researchers are studying the possible connection between SCAD and hormonal changes in women. Hormones such as oestrogen and progesterone can influence blood-vessel tissue and structure. While these hormones are not considered a direct cause of SCAD, fluctuations in hormone levels may affect the strength of artery walls in some women. The period following pregnancy may also be relevant. Some SCAD cases have been reported after childbirth, including during the early days following delivery.
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Who Should Be More Careful?
One of the challenges with SCAD is that the affected person may not have the conventional risk factors associated with heart attacks. A woman may be young, physically active and have no history of diabetes, high cholesterol or smoking. This can sometimes lead to chest discomfort being dismissed because she appears otherwise healthy. Chest pain or discomfort is a common symptom of SCAD. Doctors may also identify changes on an ECG and detect heart-related markers through blood tests. Therefore, being young, having a normal body weight or being physically fit does not completely rule out the possibility of a heart attack.
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Can Stress Or Intense Exercise Trigger SCAD?
There is no single known cause of SCAD. Research has identified several possible associations, including intense physical exertion, heavy lifting, severe emotional stress, pregnancy and hormonal changes. Some patients have reported experiencing significant physical or emotional stress before developing SCAD. Another condition that has been linked with SCAD is fibromuscular dysplasia (FMD), a disorder that can affect the structure of blood vessels without the typical buildup of fatty deposits.
How Is SCAD Treated?
Treatment for SCAD depends on the individual patient's condition and the extent of the artery blockage. If blood flow needs to be restored urgently because an artery is completely blocked, angioplasty may be required. However, doctors may avoid placing a stent in some SCAD cases because the procedure can potentially worsen the injury inside the artery. When the artery is not completely blocked and the patient's condition is stable, doctors may instead monitor the patient in hospital. In some cases, the affected artery can heal on its own over time. Medications may also be prescribed depending on the patient's condition.
Can Women Return To A Normal Life After SCAD?
A SCAD diagnosis does not necessarily mean that a person has to stop exercising permanently. Once the heart has recovered, patients can generally return to physical activity according to their doctor's advice. Light resistance exercises and moderate aerobic activity may be possible, depending on the individual's condition. However, strenuous workouts, heavy weightlifting and exercise that places excessive stress on the body may need to be avoided, particularly during recovery.
Why Awareness About SCAD Matters
SCAD highlights why heart attack symptoms should not be ignored simply because a person is young or appears healthy. Women experiencing new or unexplained chest pain, pressure or discomfort should seek medical evaluation rather than assuming that age or fitness makes a heart problem unlikely. Early assessment is particularly important when symptoms are sudden or severe.
[Disclaimer: The information provided in the article is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]