SCAD, a nonatherosclerotic form of coronary artery disease, occurs when a tear or
hematoma occurs in the coronary artery wall, reducing blood flow to the heart, often
leading to MI.
1
Unlike other forms of acute coronary syndrome (ACS), SCAD disproportionally afflicts
women (77%-98% of cases) and patients seldom have traditional cardiovascular risk
factors (eg, dyslipidemia or smoking).
1
Psychologic triggers are prominent precursors; 56% of patients with SCAD reported
precipitative distress, whereas the premorbid psychiatric status of patients with
ACS ranges much lower (10%-24%). Burgeoning research indicates that depressed mood
and anxiety are also prevalent (up to 71%) after SCAD. These rates are 3 to 4 times
higher than in the general population. Assessing and responding to these high distress
levels is critical because psychiatric symptoms after MI are known to increase the
risk of MI recurrence by 50% and mortality by 3- to 4-fold.To read this article in full you will need to make a payment
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References
- Spontaneous coronary artery dissection: JACC state-of-the-art review.J Am Coll Cardiol. 2020; 76: 961-984
- The first dedicated cardiac rehabilitation program for patients with spontaneous coronary artery dissection: description and initial results.Can J Cardiol. 2016; 32: 554-560
- Usefulness of cardiac rehabilitation after spontaneous coronary artery dissection.Am J Cardiol. 2016; 117: 1604-1609
- Psychological and clinical characteristics of patients with spontaneous coronary artery dissection: a case-control study.Int J Cardiol. 2021; 323: 1-6
- Preliminary support for group cognitive behavioural therapy (CBT) to reduce psychological distress in patients with spontaneous coronary artery dissection (SCAD).J Clin Psychol Med Settings. 2021; 28: 826-832
Article info
Publication history
Published online: January 13, 2023
Accepted:
January 10,
2023
Received:
September 30,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Twitter: @HeatherETulloch
See page 3 for disclosure information.
Identification
Copyright
© 2023 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
