Spontaneous Coronary Artery Dissection

Spontaneous coronary artery dissection (SCAD) causes 35% of myocardial infarctions in women under the age of 50 years old. Typically, these are healthy, active women without risk factors for atherosclerotic coronary artery syndromes. SCAD is a myocardial infarction caused by a coronary arterial dissection and not atherosclerotic plaques. Because of this, those effected do not present with the typical risk factors associated with acute atherosclerotic coronary syndromes. Therefore, clinicians must maintain a high level of suspicion for SCAD in young, healthy, women presenting with chest pain. Observation and pharmacological therapies are the preferred methods of treatment for a SCAD event. Post-SCAD care must also be tailored to the otherwise healthy individual and may include cardiac rehabilitation, counseling, stress management, evaluation for extracoronary vascular abnormalities, exercise and activity counseling, pregnancy prevention counseling, blood pressure management with a goal of 120/80 or less, and avoidance of triptan treatment of migraine headaches