Materiały źródłowe

• #1 Spontaneous Coronary Artery Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK582143/

  Spontaneous coronary artery dissection (SCAD) is a tear in the wall of the epicardial coronary artery not caused by trauma, coronary intervention, or atherosclerotic plaque rupture. […] The etiopathogenesis of this entity is unclear, and studies are underway. The hypotheses proposed in the literature are about its association with fibromuscular dysplasia (FMD), exposure to female sex hormones like estrogen and progesterone, and extreme physical or emotional stress. […] The etiology of spontaneous coronary artery dissection is unclear and hypothesized to be multifactorial. Since SCAD occurs predominantly in young females, including peripartum, it is hypothesized that female sex hormones, environmental stressors, or underlying arteriopathies like fibromuscular dysplasia (FMD) contribute to its occurrence.

• #2

  https://link.springer.com/article/10.1007/s11886-023-02019-w

  Spontaneous coronary artery dissection (SCAD) is an increasingly recognized etiology for acute coronary syndrome (ACS) in the young, accounting for 14% of all ACS cases. While SCAD has been reported in both sexes, the vast majority of cases occur in middle-aged women from ages 44 to 53 years old in the absence of traditional cardiovascular risk factors. While prior population studies report SCAD as a rare etiology for myocardial infarction, recent studies demonstrate SCAD as the cause of 35% of all ACS events in women under the age of 50 years old. […] Described triggers for SCAD include stress (physical or psychological), use of illicit substances, underlying arteriopathies, and hormonal factors such as pregnancy. Additional infrequent, but important, triggers include inflammatory disorders such as inflammatory bowel disease or systemic vasculitides such as Takayasu arteritis.

• #3 Spontaneous coronary artery dissection (SCAD) | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20188640/

  Spontaneous coronary artery dissection is an emergency condition that occurs when a tear forms in a wall of a heart artery. Spontaneous coronary artery dissection also is called SCAD. […] The cause of spontaneous coronary artery dissection is unknown. […] SCAD can happen after extreme stress. This includes intense physical exercise and severe emotional distress. […] Genetic conditions affecting connective tissue. Ehlers-Danlos and Marfan syndromes have been found to occur in people who have had SCAD. […] Very high blood pressure. Severe high blood pressure can raise the risk of SCAD. […] Illegal drug use. Using cocaine or other illegal drugs might increase the risk of SCAD.

• #4 Causes of Spontaneous Coronary Artery Dissection | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/spontaneous-coronary-artery-dissection/causes.html

  Spontaneous coronary artery dissection (SCAD) happens when layers in the artery wall tear apart without warning, and partially or completely block blood flow to the heart. This condition typically presents as a heart attack and is often misdiagnosed. SCAD most frequently affects women, many of them young and otherwise healthy. […] The causes of spontaneous coronary artery dissection (SCAD) remain unknown. It often affects people who are young, active, otherwise healthy, and largely free of the typical risks for heart disease. […] Ongoing research has provided a few clues on potential causes: […] Some cases of SCAD might develop from genetic mutations inherited from parents. […] Some studies indicate a hormonal connection. Nearly one-third of female SCAD patients recently gave birth. The condition also seems to occur more in women during their menstrual cycle, or close to entering it. […] Studies show a tie to fibromuscular dysplasia, which causes unusual cell growth in the arteries. […] Exercise appears to play some role, but more commonly for men. Men with SCAD typically engaged in highly strenuous exercise beforehand.

• #5 Spontaneous coronary artery dissection (SCAD) | Heart and Stroke Foundation

  https://www.heartandstroke.ca/heart-disease/conditions/spontaneous-coronary-artery-dissection

  Spontaneous Coronary Artery Dissection (SCAD) is a tear in an artery wall in your heart that allows blood to build up in the space between the layers of your artery wall. This leads to a reduction or blockage of blood flow to your heart, which causes damage to your heart muscle and affects your heart rhythm. Reduced blood flow could cause a heart attack or cardiac arrest (cardiopulmonary arrest). […] The cause of SCAD is still unknown. It is believed that it starts with your artery wall weakening. Possible causes of weakened artery walls are: fibromuscular dysplasia, genetics, multiple pregnancies, connective tissue disorders, systemic inflammations (like Crohns disease), hormonal changes/therapy, cocaine use. […] SCAD can also be triggered by highly emotional events (death of loved one, job loss, breakdown of marriage) or physical stresses (giving birth, weight lifting, intensive workout, straining bowel movement, coughing, retching/vomiting). In a recent study, more than half of patients experienced an emotionally or physically stressful event around the time of their SCAD.

• #6 Coronary Artery Dissection: Not Just a Heart Attack | American Heart Association

  https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks/coronary-artery-dissection-not-just-a-heart-attack

  Spontaneous coronary artery dissection (SCAD) happens when an artery wall suddenly tears. […] Researchers aren’t sure what causes SCAD. […] Other risk factors for SCAD are having dangerously high blood pressure and substance use disorders. […] Scientists think that multiple factors may cause SCAD, such as: Abnormalities in the arteries, Genetics, Hormonal influences, Inflammatory issues. […] Physical or emotional stress are often reported to have happened before SCAD. […] SCAD can happen in men and people of nearly any age. But it does happen most in women in their 40s and 50s. […] Pregnancy-related SCAD is a small percentage of all SCAD cases. It’s also the most common cause of heart attacks during pregnancy. […] SCAD can cause a life-threatening heart attack. […] SCAD patients don’t typically have other heart disease risk factors.

• #7 Spontaneous Coronary Artery Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK582143/

  Spontaneous coronary artery dissection is the most common cause of ACS in young women without any conventional cardiovascular risk factors. The disproportionately high incidences of SCAD in young women, including those who are pregnant, postpartum, or on oral contraceptive pills, suggests a possible role of female sex hormones. […] Studies have also shown a possible association between extreme physical or emotional stress and SCAD. One study found antecedent extreme physical stressors in 40% and emotional stressors in 24% of SCAD patients.

• #8 Spontaneous Coronary Artery Dissection (SCAD)

  https://my.clevelandclinic.org/health/diseases/17503-spontaneous-coronary-artery-dissection-scad

  In rare instances, the force of severe vomiting or coughing may cause the artery wall to tear. A traumatic accident or a medical procedure like a cardiac catheterization can cause a coronary artery dissection. This type of tear has a known cause. […] People with certain conditions may be more prone to coronary artery dissection. These conditions include connective tissue diseases like Marfan syndrome, dangerously high blood pressure, fibromuscular dysplasia (FMD), hypothyroidism, inflammatory diseases like lupus, multiple sclerosis (MS) and sarcoidosis, and substance use disorder. […] SCAD can be life-threatening, claiming the lives of up to 5% of people who develop it. An artery tear increases your risk for chronic angina, disease recurrence, and heart inflammation. […] Spontaneous coronary artery dissection (SCAD) causes heart attack-like symptoms among people who are at low risk for heart problems. Females are most at risk.

• #9 Spontaneous Coronary Artery Dissection: Clinical Considerations in Diagnosis and Treatment – American College of Cardiology

  https://www.acc.org/Latest-in-Cardiology/Articles/2019/12/20/11/41/Spontaneous-Coronary-Artery-Dissection

  Spontaneous coronary artery dissection (SCAD) is a unique clinical entity and an important cause of myocardial infarction (MI), particularly among young and middle-aged women. SCAD is defined as a non-iatrogenic, non-traumatic separation of the coronary artery wall, not associated with atherosclerosis. […] The predominant mechanism of myocardial injury is coronary artery obstruction caused by an intramural hematoma (IMH) or intimal disruption compromising the true lumen at the site of dissection. […] The original studies implicated SCAD as the cause of acute coronary syndrome in 0.1% to 4% of cases, but more recent studies have shown SCAD to be the underlying cause of MI in 22-43% of women <50 years. [...] A paucity of data exists regarding optimal management of SCAD due to lack of randomized trials comparing medical therapy and revascularization strategies.

• #10 SCAD Causes, Symptoms, and Treatments

  https://www.upmc.com/services/heart-vascular/conditions/spontaneous-coronary-artery-dissection

  Spontaneous Coronary Artery Dissection (SCAD) is a tear or dissection that forms in the coronary artery wall. SCAD occurs when the coronary arteries, which supply blood and oxygen to your heart muscle, have a tear or dissection. […] SCAD is the most common cause of heart attack in women in their 40s and 50s. […] SCAD is the cause of about 25 percent of heart attacks in women under age 60 and is the leading cause of pregnancy-associated heart attacks. […] Doctors and researchers haven’t learned the exact cause of SCAD. […] Researchers have identified certain factors that may increase your risk of SCAD: Autoimmune diseases, childbirth, gender, high blood pressure, inherited connective tissue disease, intense exercise or severe emotional stress, and underlying blood vessel disorders. […] Left undiagnosed or untreated, SCAD can lead to heart attack and even death. […] Undiagnosed and untreated, SCAD can damage the heart muscle and affect heart rhythm.

• #11 Sex Differences in Spontaneous Coronary Artery Dissection | USC Journal

  https://www.uscjournal.com/articles/sex-and-gender-differences-cardiovascular-disease-review-spontaneous-coronary-artery?language_content_entity=en

  Spontaneous coronary artery dissection (SCAD) is a cause of acute coronary syndrome (ACS) secondary to an epicardial coronary artery dissection that is not associated with atherosclerosis or trauma and is not iatrogenic. Myocardial injury is caused by the development of a dissection flap or intramural hematoma in the tunica media leading to coronary obstruction. Two hypotheses have been proposed to explain the pathophysiological process: the inside-out hypothesis, in which blood enters the subintimal space after an endothelial-intimal disruption, and the outside-in hypothesis, in which intramural hematoma arises de novo by rupture of the vasa vasorum. […] […] SCAD has a unique demographic and risk factor profile, with women comprising approximately 90% of cases. SCAD is believed to be the etiology of MI in 24-35% of women below the age of 60 years. The cause of SCAD is multifactorial with genetic factors, hormones, and arteriopathies playing a role, as well as environmental or emotional stressors precipitating the event. Evidence suggests that SCAD is preceded by an emotional event in 40-56% of cases, while 18-24% of cases are preceded by heavy physical exertion. […]

• #12 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Spontaneous-Coronary-Artery-Dissection-(SCAD).aspx

  Myocardial ischemia and symptoms associated with this are thought to be the result of either: Bulging of the compressed intima by the formation of an intramural hematoma, Extension of the dissection by forward-moving blood flow causes an obstructive false lumen, Due to the disturbed hemodynamics and exposed components of the vessel wall to the bloodstream, the incidence of thrombosis, The arterial dissection and the subsequent healing process could cause chest pain in the absence of myocardial ischemia.

• #13 What is SCAD? – Information for Patients | Beat SCAD

  https://beatscad.org.uk/SCAD-for-Patients/What-is-SCAD

  Spontaneous Coronary Artery Dissection (SCAD) is an uncommon heart condition that cant be predicted or prevented yet. […] The cause of false lumen formation is unclear but there are currently two theories for the mechanism: […] Growing evidence suggests this is the likely predominant or exclusive mechanism of SCAD. […] SCAD has been reported across a wide age range (18-84 years) but the majority of cases are in young- to middle-aged women with an average age of 50. […] Around 10% of patients are male and, because SCAD patients are predominantly female and it’s thought there is a hormonal association, this is an area of interest to researchers as men don’t go through the hormonal fluctuations women do, so may provide clues about what causes SCAD. […] SCAD patients have few or none of the traditional risk factors associated with heart disease (atherosclerosis). More research is needed to understand why fit, healthy people have SCADs. […] We dont yet know what causes SCAD. Some associations have been described with: […] Recent research has identified genetic variants that confer a higher risk of having a SCAD, but it is not caused by a single gene in the same way hereditary diseases are.

• #14 Spontaneous coronary artery dissection causes – wikidoc

  https://www.wikidoc.org/index.php/Spontaneous_coronary_artery_dissection_causes

  The association between FMD and SCAD has been well described. The biological proof of causation has been supported by histopathologic reports. The presence of FMD may weaken the artery architecture and lead to aneurysm formation or coronary dissection. […] Both TCM and SCAD affect predominantly women and may be precipitated by emotional stress or strenuous exercise associated with sympathetic discharge. Numerous reports have described the concurrence of TCM and SCAD. In the setting of TCM, vigorous contraction of the left ventricular base in conjunction with the adjacent akinetic/dyskinetic segments could form a prerequisite anatomic/functional substrate for the causation of SCAD. The coronary dissection plane may develop as a result of excessive movement of the epicardial vessels and increased shear stress on the vessel wall at the hinge point between the hyperdynamic and dyskinetic/akinetic myocardium. Another plausible mechanism is that elevated catecholamine concentrations in TCM may cause epicardial coronary vasoconstriction and/or spasm, which in turn leads to increased arterial shear stress and subsequent intimal tear or disruption of vasa vasorum. The post-ischemic myocardial stunning associated with SCAD could lead to TCM, thus forming the TCM begets SCAD, and SCAD begets TCM vicious cycle.

• #15 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Spontaneous-Coronary-Artery-Dissection-(SCAD).aspx

  Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic, nontraumatic separation of the coronary arterial walls and causes acute coronary syndrome and sudden cardiac death. […] This dissection separation creates a false lumen that may exist between the intima and media or between the media and adventitia. […] The pathology of SCAD comprises an acute and spontaneous separation of the coronary artery wall layers, forming an intramural space (false lumen). […] This subsequently causes a lumen compression, leading to ischemia and acute myocardial infarction. […] The initiation of this event is proposed to be a hemorrhage at some point in the tunica media or adventitia; however, it remains to be seen whether or not the intimal tear could be the primary event when it is present.

• #16 Spontaneous coronary artery dissection—A review – Yip – Cardiovascular Diagnosis and Therapy

  https://cdt.amegroups.org/article/view/5668/html

  Spontaneous coronary artery dissection (SCAD) is an infrequent and often missed diagnosis among patients presenting with acute coronary syndrome (ACS). SCAD can result in significant morbidities such as myocardial ischemia and infarction, ventricular arrhythmias and sudden cardiac death. […] SCAD is defined as a non-traumatic and non-iatrogenic separation of the coronary arterial walls, creating a false lumen. This separation can occur between the intima and media or between the media and adventitia, with intramural hematoma (IMH) formation within the arterial wall that compresses the arterial lumen, decreasing antegrade blood flow and subsequent myocardial ischemia or infarction. […] The usual pathogenesis of ACS involves atherosclerotic plaque rupture that is distinct from non-atherosclerotic forms of SCAD. Dissections due to atherosclerosis tend to be less extensive, as medial atrophy and scarring from atherosclerosis limits propagation of the dissection. Non-atherosclerotic SCAD is typically a culmination of disease pathways that predispose arterial beds to injury. These include fibromuscular dysplasia (FMD), multiple pregnancy, systemic inflammation, connective tissue disorder, hormonal therapy, and coronary artery spasm.

• #17 Spontaneous coronary artery dissection, a commonly overlooked etiology of acute coronary syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7427437/

  Spontaneous coronary artery dissection (SCAD) is a type of non-atherosclerotic coronary artery disease, initially thought to be uncommon but is now being increasingly recognized as a cause of acute coronary syndrome in females. […] The risk factors for SCAD include female sex, young age, extreme emotional stress, exertion, pregnancy, fibromuscular dysplasia and it is also associated with inherited connective tissue diseases such as Marfan syndrome, Ehlers-Danlos, and Loeys-Dietz syndrome. […] The exact prevalence of SCAD remains unclear and reported prevalence ranges from 0.1% to 25%. […] The risk factors of SCAD have been poorly elaborated till date. Initially, SCAD was thought to be only associated with hormonal and hemodynamic changes due to pregnancy and postpartum state but risk factors now include female sex, young age, extreme emotional stress, exertion, and fibromuscular dysplasia.

• #18

  https://link.springer.com/article/10.1007/s12471-019-1235-4

  Spontaneous coronary artery dissection (SCAD) represents around 25% of cases of acute coronary syndromes (ACS) in women aged 4065 years who have few or no traditional cardiovascular risk factors. […] It is estimated that up to 25% of all ACS in this age group are caused by SCAD, although the diagnosis is often missed. […] SCAD is defined as a spontaneous tear in the coronary arterial wall due to non-atherosclerotic and non-iatrogenic causes. […] The underlying pathophysiology of SCAD is multifactorial, related to underlying arteriopathies, inflammation, hormonal factors and mixed connective tissue diseases, whereas the acute event is often preceded by emotional or physical triggers. […] Predisposing factors which are associated with SCAD are fibromuscular dysplasia (FMD), female gender, pregnancy-related factors, possibly hormonal therapy, mixed connective tissue disorders and inflammatory disorders.

• #19 Spontaneous Coronary Artery Dissection (SCAD) | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/spontaneous-coronary-artery-dissection.html

  Spontaneous coronary artery dissection (SCAD) happens when layers in the artery wall tear apart without warning, and partially or completely block blood flow to the heart. […] SCAD most frequently affects women, many of them young and otherwise healthy. […] SCAD can develop in more than one artery and is commonly mistaken for other artery problems, such as coronary vasospasm or atherosclerosis. […] Women represent an estimated 90% of the population with SCAD.

• #20 Spontaneous Coronary Artery Dissection in Clinical Practice: Pathophysiology and Therapeutic Approaches

  https://www.mdpi.com/1648-9144/60/2/217

  The pathophysiology of SCAD and its management is different to type 1 AMI. The latter is based on the well-known atherosclerotic plaque disruption complicated by coronary atherothrombosis. Regarding SCAD, instead, two main pathogenetic mechanisms have been described: (i) a mechanism concerning the more external arterial wall layers characterized by a possible vasa vasorum rupture with consequent arterial wall bleeding; (ii) a mechanism starting from the inner wall layers characterized by intima tearing and consequent false lumen formation with media hemorrhage and true lumen compression. […] Female gender is the most well-known and strongest predisposing factor, accounting for up to 90% of SCAD cases. In particular, pregnancy, multiparity, peri and post-partum status, and hormonal therapy are major risk factors for SCAD, suggesting a key role for sex-related hormones.

• #21 What is SCAD? – Information for Patients | Beat SCAD

  https://beatscad.org.uk/SCAD-for-Patients/What-is-SCAD

  Spontaneous Coronary Artery Dissection (SCAD) is an uncommon heart condition that cant be predicted or prevented yet. […] The cause of false lumen formation is unclear but there are currently two theories for the mechanism: […] Growing evidence suggests this is the likely predominant or exclusive mechanism of SCAD. […] SCAD has been reported across a wide age range (18-84 years) but the majority of cases are in young- to middle-aged women with an average age of 50. […] Around 10% of patients are male and, because SCAD patients are predominantly female and it’s thought there is a hormonal association, this is an area of interest to researchers as men don’t go through the hormonal fluctuations women do, so may provide clues about what causes SCAD. […] SCAD patients have few or none of the traditional risk factors associated with heart disease (atherosclerosis). More research is needed to understand why fit, healthy people have SCADs. […] We dont yet know what causes SCAD. Some associations have been described with: […] Recent research has identified genetic variants that confer a higher risk of having a SCAD, but it is not caused by a single gene in the same way hereditary diseases are.

• #22 How and when to suspect spontaneous coronary artery dissection: novel insights from a single-centre series on prevalence and angiographic appearance | EuroIntervention

  https://eurointervention.pcronline.com/article/how-and-when-to-suspect-spontaneous-coronary-artery-dissection-novel-insights-from-a-single-centre-series-on-prevalence-and-angiographic-appearance

  Spontaneous coronary artery dissection (SCAD) is an underdiagnosed entity of acute coronary syndrome (ACS). Its overall prevalence remains unclear, varying from 0.1% to 1.1% in most angiographic series. Several reasons indicate that this is an underdiagnosed condition. First, presentation as sudden death, with the diagnosis established post mortem on autopsy findings in early reports, may at least partially explain the underrecognition of this condition. Second, the widespread belief among physicians that young women are at low risk of acute coronary events is responsible for an underuse of coronary angiography in young females with chest pain. Third, the well-known limitations of coronary angiography in visualising the vessel wall contribute to the misdiagnosis of SCAD, especially in cases of intramural haematoma without intimal rupture. The pathognomonic appearance of dissection with intimal rupture as a radiolucent flap is easily recognisable on angiography. In contrast, the assessment of luminal narrowing in case of intramural haematoma is more subtle, and remains a challenge for clinicians confronted with a suspicion of SCAD. Large series of patients have recently been published providing additional insights on the prevalence and diagnosis of this poorly understood disease. In the light of these recent data, the prevalence of SCAD is much higher than previously described. Indeed, Saw et al showed that SCAD accounts for almost 25% of all ACS with MI in women under 50 years of age. A recently proposed classification provides additional help for the diagnosis and distinguishes two angiographic aspects of intramural haematoma: i) long and diffuse stenosis varying in severity from mild to complete occlusion and involving distal arterial segments (Type 2), or ii) more focal stenosis mimicking atherosclerosis (Type 3). In case of ambiguities, the value of optical coherence tomography (OCT) has been demonstrated to assess arterial wall integrity and to diagnose both dissection and intramural haematoma. Despite these recent data, there is still a need to assess the prevalence of SCAD and to increment specific angiographic semiotics to facilitate SCAD recognition.

• #23 Coronary Artery Dissection: Not Just a Heart Attack | American Heart Association

  https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks/coronary-artery-dissection-not-just-a-heart-attack

  Spontaneous coronary artery dissection (SCAD) happens when an artery wall suddenly tears. […] Researchers aren’t sure what causes SCAD. […] Other risk factors for SCAD are having dangerously high blood pressure and substance use disorders. […] Scientists think that multiple factors may cause SCAD, such as: Abnormalities in the arteries, Genetics, Hormonal influences, Inflammatory issues. […] Physical or emotional stress are often reported to have happened before SCAD. […] SCAD can happen in men and people of nearly any age. But it does happen most in women in their 40s and 50s. […] Pregnancy-related SCAD is a small percentage of all SCAD cases. It’s also the most common cause of heart attacks during pregnancy. […] SCAD can cause a life-threatening heart attack. […] SCAD patients don’t typically have other heart disease risk factors.

• #24 What is spontaneous coronary artery dissection (SCAD)? – Sunnybrook Hospital

  https://sunnybrook.ca/content/?page=what-is-scad

  Although up to 10% of patients with SCAD were taking hormonal therapy, so far there is no conclusive evidence that hormonal therapy causes SCAD or increases the risk of SCAD recurrence. […] Very few genes have been identified that have an association with SCAD. […] SCAD patients have lower rates of traditional cardiovascular risk factors. […] Patients with SCAD report higher rates of emotional and physical stressors.

• #25 Spontaneous Coronary Artery Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK582143/

  Spontaneous coronary artery dissection (SCAD) is a tear in the wall of the epicardial coronary artery not caused by trauma, coronary intervention, or atherosclerotic plaque rupture. […] The etiopathogenesis of this entity is unclear, and studies are underway. The hypotheses proposed in the literature are about its association with fibromuscular dysplasia (FMD), exposure to female sex hormones like estrogen and progesterone, and extreme physical or emotional stress. […] The etiology of spontaneous coronary artery dissection is unclear and hypothesized to be multifactorial. Since SCAD occurs predominantly in young females, including peripartum, it is hypothesized that female sex hormones, environmental stressors, or underlying arteriopathies like fibromuscular dysplasia (FMD) contribute to its occurrence.

• #26 Spontaneous Coronary Artery Dissection (SCAD) – Victor Chang Cardiac Research Institute

  https://www.victorchang.edu.au/heart-disease/scad

  Spontaneous coronary artery dissection (SCAD) is a very rare condition and not enough medical research has been done into the disease, so the causes are largely unknown. However, it is likely a combination of factors and causes that can trigger SCAD. These include: […] For men and women, extreme exertion and extreme stress appear to play a role. […] Having fibromuscular dysplasia (FMD) which is a closely related blood vessel disorder. About half of SCAD sufferers also have FMD. […] Research suggests it also accounts for up to 24% of cases of heart attack in women under the age of 50. […] The Institute helped identify the first ever gene to be linked to SCAD PHACTR1. This gene has been identified as having one of the strongest genetic associations with SCAD. […] The Institute has also been involved in research that has identified genetic links between SCAD and connective tissue disorders (such as Ehlers Danlos syndrome).

• #27 Spontaneous coronary artery dissection

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-14/spontaneous-coronary-artery-dissection

  The high prevalence of FMD in patients with SCAD suggests a direct causative association. […] The first reported association between SCAD and FMD was made in 2005 by a group in Vancouver, Canada. […] Pregnancy-related SCAD accounts for a small proportion (less than 5%) of all SCAD cases and is a less important cause of SCAD than originally reported. […] Hormonal changes during pregnancy with high progesterone levels can result in weakening of the vessel wall. […] The risk of recurrence is thought to be significant, with one small study showing that pregnancy-related SCAD occurred in one out of seven patients who became pregnant from a 266-patient SCAD registry. […] Therefore, women of a reproductive age with a history of SCAD due to any cause should be carefully counselled regarding the risk of recurrent events, especially if they are planning a future pregnancy.

• #28 2. Risk Factors for SCAD – SCAD Alliance

  https://scadalliance.org/scad-warrior-app/risk-factors-for-scad-2/

  Doctors and researchers have found some apparent risk factors for spontaneous coronary artery dissection (SCAD), though it’s unclear exactly what role these factors play in causing the disease. These factors include: […] Female sex. Though SCAD occurs in men, too, it tends to affect women much more often. […] Giving birth. Some SCAD occurs in women who have recently given birth, especially in the first few weeks postpartum. […] Underlying blood vessel conditions. Some abnormalities have been associated with SCAD, most commonly fibromuscular dysplasia (FMD), which causes the irregular growth of cells in the walls of one or more of your arteries. This irregular growth can weaken the artery walls, leading to blockages, dissections or aneurysms, and can also cause high blood pressure, strokes and tears in other blood vessels. FMD occurs more often in women than it does in men. Lupus and polyarteritis nodosa, which cause inflammation of the blood vessels, have also been associated with SCAD.

• #29

  https://link.springer.com/article/10.1007/s11886-023-02019-w

  Hormones have been implicated in the pathogenesis of SCAD due to the strong predilection for women and its association with pregnancy. However, this association is not well understood. Prior reports show similar prevalence of SCAD for both premenopausal and postmenopausal women. Additionally, SCAD prevalence in cohort studies appears similar regardless of pregnancy history. […] In patients presenting with SCAD, underlying systemic vasculopathy must be considered. Prior large cohort studies and registry data have solidified the association of SCAD with fibromuscular dysplasia (FMD), with reported rates of FMD occurring typically from 45 to 77% in patients screened for extracoronary vascular abnormalities. […] Research to identify genetic determinants of SCAD is ongoing. Not infrequently, patients presenting with SCAD may undergo screening for connective tissue diseases and aortopathies such as Loeys-Dietz, Ehlers-Danlos, and Marfan syndrome.

• #30 Spontaneous coronary artery dissection: a clinically oriented narrative review | npj Cardiovascular Health

  https://www.nature.com/articles/s44325-024-00004-y

  The prevalence of FMD among patients with SCAD was variable between studies. […] In the balance of current evidence, FMD screening has been advocated for in all patients with SCAD. […] SCAD is one of the most common causes of MI in pregnant women with the post-partum period the most at-risk period. […] Pregnancy-related SCAD (P-SCAD) usually has higher incidences of ST elevation myocardial infarction, reduced left ventricular ejection fraction, involvement of the left main artery or multivessel SCAD.

• #31 Spontaneous coronary artery dissection causes – wikidoc

  https://www.wikidoc.org/index.php/Spontaneous_coronary_artery_dissection_causes

  The association between FMD and SCAD has been well described. The biological proof of causation has been supported by histopathologic reports. The presence of FMD may weaken the artery architecture and lead to aneurysm formation or coronary dissection. […] Both TCM and SCAD affect predominantly women and may be precipitated by emotional stress or strenuous exercise associated with sympathetic discharge. Numerous reports have described the concurrence of TCM and SCAD. In the setting of TCM, vigorous contraction of the left ventricular base in conjunction with the adjacent akinetic/dyskinetic segments could form a prerequisite anatomic/functional substrate for the causation of SCAD. The coronary dissection plane may develop as a result of excessive movement of the epicardial vessels and increased shear stress on the vessel wall at the hinge point between the hyperdynamic and dyskinetic/akinetic myocardium. Another plausible mechanism is that elevated catecholamine concentrations in TCM may cause epicardial coronary vasoconstriction and/or spasm, which in turn leads to increased arterial shear stress and subsequent intimal tear or disruption of vasa vasorum. The post-ischemic myocardial stunning associated with SCAD could lead to TCM, thus forming the TCM begets SCAD, and SCAD begets TCM vicious cycle.

• #32 Coronary artery dissection | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/coronary-artery-dissection?lang=us

  Coronary artery dissection is a rare cause of acute coronary syndrome especially in young patients who are otherwise healthy. A spontaneous coronary artery dissection (SCAD) is defined as a non-iatrogenic dissection of an epicardial coronary artery not associated with atherosclerosis or trauma. […] Coronary artery dissection is believed to be due to an intramural hematoma in the wall of a coronary vessel creating a false lumen which then causes occlusion of the true lumen. […] Many cases are idiopathic although it has been associated with many conditions […] fibromuscular dysplasia: considered the most common coexisting condition and according to some report has been present in up to 86% of cases of spontaneous coronary artery dissection. […] The survival from coronary artery dissection in one study was quoted to be up to 82% in long term follow up. […] Spontaneous coronary artery dissection was first reported at autopsy by H C Pretty in 1931.

• #33 Spontaneous Coronary Artery Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK582143/

  Spontaneous coronary artery dissection is the most common cause of ACS in young women without any conventional cardiovascular risk factors. The disproportionately high incidences of SCAD in young women, including those who are pregnant, postpartum, or on oral contraceptive pills, suggests a possible role of female sex hormones. […] Studies have also shown a possible association between extreme physical or emotional stress and SCAD. One study found antecedent extreme physical stressors in 40% and emotional stressors in 24% of SCAD patients.

• #34

  https://link.springer.com/article/10.1007/s12471-019-1235-4

  It is believed that female sex hormones, especially progesterone, which are high in premenopausal women and during pregnancy, influence the integrity of arterial walls. […] Although uncommon, mixed connective tissue disorders (MCTD) predispose for SCAD, since these are associated with arterial fragility and vascular dissection. […] Systemic inflammatory disorders associated with SCAD are systemic lupus erythematosus, Crohns disease, ulcerative colitis, rheumatoid arthritis and coeliac disease.

• #35 Sex Differences in Spontaneous Coronary Artery Dissection | USC Journal

  https://www.uscjournal.com/articles/sex-and-gender-differences-cardiovascular-disease-review-spontaneous-coronary-artery?language_content_entity=en

  SCAD is the most common etiology of MI in pregnant patients, often presenting more severely and with a higher prevalence of ST-elevation MI (STEMI) than SCAD in patients who are not pregnant. Pregnancy-associated SCAD (p-SCAD) accounts for approximately 5-10% of all SCAD cases, with most events occurring in the third trimester and the early postpartum period. […] […] Sex hormones have been implicated in the pathophysiology and development of SCAD given its predilection for women, including its strong association with pregnancy and peri-menopausal/menopausal period. SCAD events have been shown to occur just before or during menstruation in premenopausal females, corresponding to the luteal phase of the menstrual cycle, and shortly after pregnancy in postpartum females. During these two time periods, the levels of circulating estrogen and progesterone typically decline, implicating estrogen withdrawal or relative changes in the level of circulating estrogen and progesterone in females as a potential hormone hypothesis for SCAD. […]

• #36 Spontaneous coronary artery dissection

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-14/spontaneous-coronary-artery-dissection

  The high prevalence of FMD in patients with SCAD suggests a direct causative association. […] The first reported association between SCAD and FMD was made in 2005 by a group in Vancouver, Canada. […] Pregnancy-related SCAD accounts for a small proportion (less than 5%) of all SCAD cases and is a less important cause of SCAD than originally reported. […] Hormonal changes during pregnancy with high progesterone levels can result in weakening of the vessel wall. […] The risk of recurrence is thought to be significant, with one small study showing that pregnancy-related SCAD occurred in one out of seven patients who became pregnant from a 266-patient SCAD registry. […] Therefore, women of a reproductive age with a history of SCAD due to any cause should be carefully counselled regarding the risk of recurrent events, especially if they are planning a future pregnancy.

• #37 Spontaneous coronary artery dissection

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-14/spontaneous-coronary-artery-dissection

  The high prevalence of FMD in patients with SCAD suggests a direct causative association. […] The first reported association between SCAD and FMD was made in 2005 by a group in Vancouver, Canada. […] Pregnancy-related SCAD accounts for a small proportion (less than 5%) of all SCAD cases and is a less important cause of SCAD than originally reported. […] Hormonal changes during pregnancy with high progesterone levels can result in weakening of the vessel wall. […] The risk of recurrence is thought to be significant, with one small study showing that pregnancy-related SCAD occurred in one out of seven patients who became pregnant from a 266-patient SCAD registry. […] Therefore, women of a reproductive age with a history of SCAD due to any cause should be carefully counselled regarding the risk of recurrent events, especially if they are planning a future pregnancy.

• #38 Sex Differences in Spontaneous Coronary Artery Dissection | USC Journal

  https://www.uscjournal.com/articles/sex-and-gender-differences-cardiovascular-disease-review-spontaneous-coronary-artery?language_content_entity=en

  SCAD is the most common etiology of MI in pregnant patients, often presenting more severely and with a higher prevalence of ST-elevation MI (STEMI) than SCAD in patients who are not pregnant. Pregnancy-associated SCAD (p-SCAD) accounts for approximately 5-10% of all SCAD cases, with most events occurring in the third trimester and the early postpartum period. […] […] Sex hormones have been implicated in the pathophysiology and development of SCAD given its predilection for women, including its strong association with pregnancy and peri-menopausal/menopausal period. SCAD events have been shown to occur just before or during menstruation in premenopausal females, corresponding to the luteal phase of the menstrual cycle, and shortly after pregnancy in postpartum females. During these two time periods, the levels of circulating estrogen and progesterone typically decline, implicating estrogen withdrawal or relative changes in the level of circulating estrogen and progesterone in females as a potential hormone hypothesis for SCAD. […]

• #39 Spontaneous Coronary Artery Dissection (SCAD) – Heart Foundation NZ

  https://www.heartfoundation.org.nz/your-heart/heart-conditions/spontaneous-coronary-artery-dissection

  Researchers believe there may be a genetic predisposition (a greater likelihood of developing it if someone else in your family has had it) but this this not yet fully understood. […] Hormonal changes brought on by menopause are thought to contribute to the risk of SCAD. […] Many people who experience SCAD have few or no risk factors for coronary artery disease, which is the most common cause of heart attacks.

• #40 Spontaneous Coronary Artery Dissection (SCAD): Causes, Symptoms, And Treatment

  https://www.netmeds.com/health-library/post/spontaneous-coronary-artery-dissection-scad-causes-symptoms-and-treatment?srsltid=AfmBOopeL_IAJwRzJ7KhtXq7PMbb1o243A-I4MxUXnLXbNqgUJpovz91

  Spontaneous Coronary Artery Dissection, also called SCAD, is a critical medical condition that develops when a tear is formed in a blood vessel in the heart. […] The exact cause of spontaneous coronary artery dissection is still not clear. […] Common risk factors of SCAD include: […] Though SCAD can develop in both men and women, it tends to affect women more than men. […] This health problem causes irregular growth of cells in the artery walls, which can weaken artery walls, resulting in blockages, dissection or aneurysms. […] Hormone therapy like oral contraceptives or infertility treatments has been highly linked to SCAD risk. […] Other medical conditions affecting blood vessels and those that cause inflammation of the blood vessels, like lupus and polyarteritis also have been related to SCAD. […] A genetic disorder that results in problems with the body’s connective tissue like vascular Ehlers-Danlos syndrome and Marfan syndrome has been found to develop SCAD. […] Severe blood pressure can increase the risk of SCAD. […] The use of illegal drugs or cocaine can increase the risk.

• #41 What is spontaneous coronary artery dissection (SCAD)? – Sunnybrook Hospital

  https://sunnybrook.ca/content/?page=what-is-scad

  Although up to 10% of patients with SCAD were taking hormonal therapy, so far there is no conclusive evidence that hormonal therapy causes SCAD or increases the risk of SCAD recurrence. […] Very few genes have been identified that have an association with SCAD. […] SCAD patients have lower rates of traditional cardiovascular risk factors. […] Patients with SCAD report higher rates of emotional and physical stressors.

• #42 Coronary Artery Dissection (SCAD): Types, Symptoms, Treatment

  https://www.healthline.com/health/heart/coronary-artery-dissection-scad

  One type of coronary artery dissection is called a spontaneous coronary artery dissection (SCAD). This happens when the tear in the inner lining causes blood to build up between the layers. […] SCAD occurs more often in women who are over 50 years old or postmenopausal, according to a 2015 review. But it is also a common cause of heart attack in women before menopause. […] Its not always clear why SCAD or other types of artery dissections occur, though there are known risk factors. […] For example, a 2021 study found that women are much more likely than men to develop SCAD. Most women who experience SCAD are in their 40s and 50s, but people who are pregnant or recently gave birth are also at higher risk of SCAD. […] A 2019 study notes that the following conditions raise the risk of both SCAD and coronary artery dissection: Ehlers-Danlos syndrome, fibromuscular dysplasia, Marfan syndrome, lupus. […] Other risk factors for SCAD and other types of artery dissections include poorly controlled high blood pressure, atherosclerosis, and other vascular conditions. […] Strenuous exercise, particularly weightlifting, has also been identified as a risk factor for SCAD and aortic dissection.

• #43 Spontaneous coronary artery dissection (SCAD) | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20188640/

  Spontaneous coronary artery dissection is an emergency condition that occurs when a tear forms in a wall of a heart artery. Spontaneous coronary artery dissection also is called SCAD. […] The cause of spontaneous coronary artery dissection is unknown. […] SCAD can happen after extreme stress. This includes intense physical exercise and severe emotional distress. […] Genetic conditions affecting connective tissue. Ehlers-Danlos and Marfan syndromes have been found to occur in people who have had SCAD. […] Very high blood pressure. Severe high blood pressure can raise the risk of SCAD. […] Illegal drug use. Using cocaine or other illegal drugs might increase the risk of SCAD.

• #44 2. Risk Factors for SCAD – SCAD Alliance

  https://scadalliance.org/scad-warrior-app/risk-factors-for-scad-2/

  Inherited connective tissue diseases. Genetic diseases that cause problems with the body’s connective tissues, such as vascular Ehlers-Danlos syndrome and Marfan syndrome, have been found in people with SCAD. […] Extreme physical exercise. People who recently participated in extreme or intense exercises may be at higher risk for SCAD. […] Severe emotional stress. Someone who has experienced significant emotional stress, such as a sudden death in the family, relationship conflicts or work stress may be at higher risk for SCAD. […] Very high blood pressure. Having untreated, severe high blood pressure can be associated with SCAD. […] Illegal drug use. Using cocaine or other illegal drugs may increase the risk of SCAD.

• #45 Spontaneous coronary artery dissection (SCAD) | Heart and Stroke Foundation

  https://www.heartandstroke.ca/heart-disease/conditions/spontaneous-coronary-artery-dissection

  Spontaneous Coronary Artery Dissection (SCAD) is a tear in an artery wall in your heart that allows blood to build up in the space between the layers of your artery wall. This leads to a reduction or blockage of blood flow to your heart, which causes damage to your heart muscle and affects your heart rhythm. Reduced blood flow could cause a heart attack or cardiac arrest (cardiopulmonary arrest). […] The cause of SCAD is still unknown. It is believed that it starts with your artery wall weakening. Possible causes of weakened artery walls are: fibromuscular dysplasia, genetics, multiple pregnancies, connective tissue disorders, systemic inflammations (like Crohns disease), hormonal changes/therapy, cocaine use. […] SCAD can also be triggered by highly emotional events (death of loved one, job loss, breakdown of marriage) or physical stresses (giving birth, weight lifting, intensive workout, straining bowel movement, coughing, retching/vomiting). In a recent study, more than half of patients experienced an emotionally or physically stressful event around the time of their SCAD.

• #46 Sex Differences in Spontaneous Coronary Artery Dissection | USC Journal

  https://www.uscjournal.com/articles/sex-and-gender-differences-cardiovascular-disease-review-spontaneous-coronary-artery?language_content_entity=en

  Many extra-coronary arteriopathies with a genetic predisposition have characteristics that overlap with SCAD, often occurring in young patients without overt risk factors for cardiovascular disease. However, our understanding of SCAD genetics continues to evolve. The genetic traits for SCAD are now thought to be polygenic as opposed to monogenic or following a Mendelian pattern, as with other previously characterized arteriopathies. SCAD incidence has been described in association with genetically triggered and familial connective tissue diseases (CTDs), such as Marfan syndrome, vascular Ehlers-Danlos syndrome (vEDS), Loeys-Dietz syndrome (LDS), polycystic kidney disease, Alport’s syndrome, and aortic aneurysm. […]

• #47 Sex Differences in Spontaneous Coronary Artery Dissection | USC Journal

  https://www.uscjournal.com/articles/sex-and-gender-differences-cardiovascular-disease-review-spontaneous-coronary-artery?language_content_entity=en

  Many extra-coronary arteriopathies with a genetic predisposition have characteristics that overlap with SCAD, often occurring in young patients without overt risk factors for cardiovascular disease. However, our understanding of SCAD genetics continues to evolve. The genetic traits for SCAD are now thought to be polygenic as opposed to monogenic or following a Mendelian pattern, as with other previously characterized arteriopathies. SCAD incidence has been described in association with genetically triggered and familial connective tissue diseases (CTDs), such as Marfan syndrome, vascular Ehlers-Danlos syndrome (vEDS), Loeys-Dietz syndrome (LDS), polycystic kidney disease, Alport’s syndrome, and aortic aneurysm. […]

• #48 Spontaneous coronary artery dissection causes – wikidoc

  https://www.wikidoc.org/index.php/Spontaneous_coronary_artery_dissection_causes

  The exact etiology of spontaneous coronary artery dissection remains elusive; however, fibromuscular dysplasia and takotsubo cardiomyopathy have been considered as the potential cause of spontaneous coronary artery dissection. The underlying causes associated with SCAD include emotional stress, physical stress such as extreme valsalva maneuver, retching, vomiting, coughing, isometric exercise, history of using stimulant medications or illicit drugs, pregnancy, and connective tissue disorders. […] Common causes associated with spontaneous coronary artery dissection (SCAD) include: Emotional stress, Physical stress such as extreme valsalva maneuver, retching, vomiting, coughing, isometric exercise, Using stimulant medications, illicit drugs, Hormonal triggers such as pregnancy, Inflammatory disorders such as systemic lupus erythematosus, sarcoidosis, Crohn’s disease, Ulcerative colitis, celiac disease, fibromuscular dysplasia (FMD), takotsubo cardiomyopathy (TCM), Connective tissue disorders such as vascular EhlersDanlos syndrome, marfans syndrome, LoeysDietz syndrome, cystic medial necrosis, systemic lupus erythematosus, polyarteritis nodosa, sarcoidosis, churg-Strauss syndrome, wegener’s granulomatosis, rheumatoid arthritis, giant cell arthritis.

• #49 Review on Spontaneous Coronary Artery Dissection – American College of Cardiology

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2020/08/19/12/09/Spontaneous-Coronary-Artery-Dissection

  SCAD causes an acute coronary event related to compression of the true lumen of a coronary artery due to hematoma within the vessel wall. The majority may be related to an “outside-in” mechanism whereby the hematoma arises de novo in the media. […] The prevalence of SCAD has been estimated to be as high as 4% of patients presenting with acute coronary syndrome, and may account for 35% of acute coronary syndromes in women aged ≤50 years. […] Genetic evaluation for connective tissue disorders and aortopathy syndromes (i.e., Marfan, Loeys-Dietz, and Ehlers-Danlos) may be considered, although these account for only 5-9% of events. Additional genetic markers and associations are being investigated and referral for formal genetic evaluation can be considered. […] SCAD is vastly more common among women and is an important cause of pregnancy-associated myocardial infarction. However, it remains incompletely understood how sex hormones contribute to the risk of SCAD.

• #50 Review on Spontaneous Coronary Artery Dissection – American College of Cardiology

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2020/08/19/12/09/Spontaneous-Coronary-Artery-Dissection

  SCAD causes an acute coronary event related to compression of the true lumen of a coronary artery due to hematoma within the vessel wall. The majority may be related to an “outside-in” mechanism whereby the hematoma arises de novo in the media. […] The prevalence of SCAD has been estimated to be as high as 4% of patients presenting with acute coronary syndrome, and may account for 35% of acute coronary syndromes in women aged ≤50 years. […] Genetic evaluation for connective tissue disorders and aortopathy syndromes (i.e., Marfan, Loeys-Dietz, and Ehlers-Danlos) may be considered, although these account for only 5-9% of events. Additional genetic markers and associations are being investigated and referral for formal genetic evaluation can be considered. […] SCAD is vastly more common among women and is an important cause of pregnancy-associated myocardial infarction. However, it remains incompletely understood how sex hormones contribute to the risk of SCAD.

• #51 Spontaneous coronary artery dissection – Wikipedia

  https://en.wikipedia.org/wiki/Spontaneous_coronary_artery_dissection

  It is likely that both genetics and environment play a role in SCAD onset. A number of genetic variants have been linked to an increased the risk of SCAD. As with dissection (medical) generally, the genes identified implicate dysfunction in four main cellular molecular pathways: the TGF- pathway, extracellular matrix pathway, vascular smooth muscle cell contractility, and cellular metabolism. Variants in genes including ALDH18A1, COL3A1, COL4A1, FBN1 and ACVR1 were implicated in a study of 91 unrelated SCAD cases.

• #52 Spontaneous coronary artery dissection – Wikipedia

  https://en.wikipedia.org/wiki/Spontaneous_coronary_artery_dissection

  It is likely that both genetics and environment play a role in SCAD onset. A number of genetic variants have been linked to an increased the risk of SCAD. As with dissection (medical) generally, the genes identified implicate dysfunction in four main cellular molecular pathways: the TGF- pathway, extracellular matrix pathway, vascular smooth muscle cell contractility, and cellular metabolism. Variants in genes including ALDH18A1, COL3A1, COL4A1, FBN1 and ACVR1 were implicated in a study of 91 unrelated SCAD cases.

• #53 Spontaneous coronary artery dissection – Wikipedia

  https://en.wikipedia.org/wiki/Spontaneous_coronary_artery_dissection

  It is likely that both genetics and environment play a role in SCAD onset. A number of genetic variants have been linked to an increased the risk of SCAD. As with dissection (medical) generally, the genes identified implicate dysfunction in four main cellular molecular pathways: the TGF- pathway, extracellular matrix pathway, vascular smooth muscle cell contractility, and cellular metabolism. Variants in genes including ALDH18A1, COL3A1, COL4A1, FBN1 and ACVR1 were implicated in a study of 91 unrelated SCAD cases.

• #54 Spontaneous Coronary Artery Dissection (SCAD) – Victor Chang Cardiac Research Institute

  https://www.victorchang.edu.au/heart-disease/scad

  Spontaneous coronary artery dissection (SCAD) is a very rare condition and not enough medical research has been done into the disease, so the causes are largely unknown. However, it is likely a combination of factors and causes that can trigger SCAD. These include: […] For men and women, extreme exertion and extreme stress appear to play a role. […] Having fibromuscular dysplasia (FMD) which is a closely related blood vessel disorder. About half of SCAD sufferers also have FMD. […] Research suggests it also accounts for up to 24% of cases of heart attack in women under the age of 50. […] The Institute helped identify the first ever gene to be linked to SCAD PHACTR1. This gene has been identified as having one of the strongest genetic associations with SCAD. […] The Institute has also been involved in research that has identified genetic links between SCAD and connective tissue disorders (such as Ehlers Danlos syndrome).

• #55 Spontaneous Coronary Artery Dissection in Clinical Practice: Pathophysiology and Therapeutic Approaches

  https://www.mdpi.com/1648-9144/60/2/217

  The genetic substrate in SCAD pathogenesis is complex, polygenic, and not yet completely understood. Both rare and common disease-associated variants have been found in several genes, which are commonly caused by single nucleotide polymorphisms (SNPs), insertions or deletions, structural variants, intronic variants, and/or short tandem repeat expansions. […] The SNP rs9349379 of the phosphatase and actin regulator 1 (PHACTR1) gene causes arterial wall pathologies, giving an increased risk not only of SCAD but also of spontaneous cervical artery dissection, migraine, and fibromuscular dysplasia. […] In conclusion, further analyses in larger cohorts are required in order to completely understand the genetic architecture of SCAD pathogenesis and to clearly define the overlap between SCAD, CTD, and vasculopathies.

• #56 Sex Differences in Spontaneous Coronary Artery Dissection | USC Journal

  https://www.uscjournal.com/articles/sex-and-gender-differences-cardiovascular-disease-review-spontaneous-coronary-artery?language_content_entity=en

  Many extra-coronary arteriopathies with a genetic predisposition have characteristics that overlap with SCAD, often occurring in young patients without overt risk factors for cardiovascular disease. However, our understanding of SCAD genetics continues to evolve. The genetic traits for SCAD are now thought to be polygenic as opposed to monogenic or following a Mendelian pattern, as with other previously characterized arteriopathies. SCAD incidence has been described in association with genetically triggered and familial connective tissue diseases (CTDs), such as Marfan syndrome, vascular Ehlers-Danlos syndrome (vEDS), Loeys-Dietz syndrome (LDS), polycystic kidney disease, Alport’s syndrome, and aortic aneurysm. […]

• #57 SCAD Research, Inc Spontaneous Coronary Artery Dissection | What is SCAD

  https://scadresearch.org/about/

  The suspected associated conditions or potential triggers for SCAD include: Pregnancy or postpartum period, Fibromuscular dysplasia (FMD), Extreme physical exertion, Extreme emotional stress, Connective-tissue abnormalities and monogenetic mutations. […] While most individuals who experience SCAD are women, SCAD can occur in men too. […] Because the causes of Spontaneous Coronary Artery Dissection (SCAD) are unknown at this point, there is no scientifically validated way to reduce the risk of SCAD occurring. […] Research has noted a substantial rate of spontaneous vascular healing and suggests a role for conservative management in stable SCAD patients who have preserved coronary flow. […] SCAD can recur, so vigilance, evaluation of associated conditions, and staying up-to-date on emerging research is also important. Statins do not appear to prevent another SCAD heart attack and one study found more recurrence in those taking statins. […] While the SCAD Research Program at Mayo Clinic has identified familial cases of in Spontaneous Coronary Artery Dissection (SCAD), occurrence of SCAD in more than one family member appears to be very rare, accounting for only ~1-2% of total cases in the Mayo Clinic registry.

• #58 Spontaneous Coronary Artery Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK582143/

  Spontaneous coronary artery dissection is the most common cause of ACS in young women without any conventional cardiovascular risk factors. The disproportionately high incidences of SCAD in young women, including those who are pregnant, postpartum, or on oral contraceptive pills, suggests a possible role of female sex hormones. […] Studies have also shown a possible association between extreme physical or emotional stress and SCAD. One study found antecedent extreme physical stressors in 40% and emotional stressors in 24% of SCAD patients.

• #59 Spontaneous Coronary Artery Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK582143/

  Spontaneous coronary artery dissection is the most common cause of ACS in young women without any conventional cardiovascular risk factors. The disproportionately high incidences of SCAD in young women, including those who are pregnant, postpartum, or on oral contraceptive pills, suggests a possible role of female sex hormones. […] Studies have also shown a possible association between extreme physical or emotional stress and SCAD. One study found antecedent extreme physical stressors in 40% and emotional stressors in 24% of SCAD patients.

• #60 Spontaneous Coronary Artery Dissection (SCAD)

  https://my.clevelandclinic.org/health/diseases/17503-spontaneous-coronary-artery-dissection-scad

  Postpartum and postmenopausal people are most at risk for spontaneous coronary artery dissection (SCAD). […] SCAD increases your risk of acute coronary syndrome. This is a type of coronary artery disease that causes chest pain or angina. […] Experts arent sure why SCAD occurs. Many people who develop this artery tear are younger and physically active. And, they dont have a known history of heart disease. […] People who develop SCAD have recently given birth. SCAD is also more likely to occur around the time of menstruation or during postmenopause. These risk factors suggest that fluctuations in female hormones may play a role. […] Males account for less than 10% of SCAD incidents. Arterial tears in men most often occur after strength training or lifting a heavy object. The physical exertion may cause the tear.

• #61 Understanding Spontaneous Coronary Artery Dissection | Banner

  https://www.bannerhealth.com/services/heart/heart-disease/scad

  Experts don’t know exactly what causes SCAD, but some factors can trigger the condition: […] Hormone fluctuations: The hormonal changes that happen during and after pregnancy may weaken the walls of the arteries and make them more likely to tear. […] Physical stress: Strenuous exercise like weightlifting or extreme yoga poses or stressors like coughing or vomiting have been linked to SCAD. […] Connective tissue disorders: Conditions like Marfan syndrome or Ehlers-Danlos syndrome may weaken the arterys walls and make them more likely to tear. […] Inflammatory conditions: Autoimmune diseases like lupus or multiple sclerosis or inflammation of the arteries (arteritis) may make SCAD more likely. […] Migraines and emotional stress: Migraines may be linked to SCAD. And sudden stressful events or long-lasting periods of stress could also be triggers.

• #62 Spontaneous Coronary Artery Dissection (SCAD)

  https://my.clevelandclinic.org/health/diseases/17503-spontaneous-coronary-artery-dissection-scad

  In rare instances, the force of severe vomiting or coughing may cause the artery wall to tear. A traumatic accident or a medical procedure like a cardiac catheterization can cause a coronary artery dissection. This type of tear has a known cause. […] People with certain conditions may be more prone to coronary artery dissection. These conditions include connective tissue diseases like Marfan syndrome, dangerously high blood pressure, fibromuscular dysplasia (FMD), hypothyroidism, inflammatory diseases like lupus, multiple sclerosis (MS) and sarcoidosis, and substance use disorder. […] SCAD can be life-threatening, claiming the lives of up to 5% of people who develop it. An artery tear increases your risk for chronic angina, disease recurrence, and heart inflammation. […] Spontaneous coronary artery dissection (SCAD) causes heart attack-like symptoms among people who are at low risk for heart problems. Females are most at risk.

• #63 Causes | SCAI – Seconds Count

  https://www.secondscount.org/condition/spontaneous-coronary-artery-dissection/causes

  Spontaneous coronary artery dissection (SCAD), though relatively uncommon, can have a tremendous impact on its victims, most of whom are young and who arent felt to be at risk for a heart attack or heart disease. Many cases of SCAD have no clear cause, but the occurrence of SCAD is often linked to several risk factors. […] Having another arterial condition, such as fibromuscular dysplasia of the renal, mesenteric, or carotid arteries or a connective tissue disorder, may predispose you to SCAD by weakening the artery wall so that a tear can more easily occur spontaneously. […] In a smaller proportion of patients, SCAD is related to a precipitating stress event such as an intense emotional jolt or physical stress, lifting heavy objects, drugs, or even bearing-down activities (retching or vomiting, coughing, or bowel movements). These movements likely increase the force exerted upon the coronary artery wall leading to its tearing. […] One of the most common conditions linked to SCAD is pregnancy. Evidence suggests that the hormone levels present during pregnancy may contribute to SCAD. Its unclear how common pregnancy-related SCAD is, but two recent studies found that about 5% of all SCAD cases were related to pregnancy.

• #64 2. Risk Factors for SCAD – SCAD Alliance

  https://scadalliance.org/scad-warrior-app/risk-factors-for-scad-2/

  Inherited connective tissue diseases. Genetic diseases that cause problems with the body’s connective tissues, such as vascular Ehlers-Danlos syndrome and Marfan syndrome, have been found in people with SCAD. […] Extreme physical exercise. People who recently participated in extreme or intense exercises may be at higher risk for SCAD. […] Severe emotional stress. Someone who has experienced significant emotional stress, such as a sudden death in the family, relationship conflicts or work stress may be at higher risk for SCAD. […] Very high blood pressure. Having untreated, severe high blood pressure can be associated with SCAD. […] Illegal drug use. Using cocaine or other illegal drugs may increase the risk of SCAD.

• #65 Spontaneous Coronary Artery Dissection or „SCAD”

  https://www.svhhearthealth.com.au/conditions/spontanous-coronary-artery-dissection

  Spontaneous coronary artery dissection, or SCAD, is when a tear suddenly occurs within the layers of one or more of the coronary arteries. This can slow down or block the blood flow to the heart, leading to a heart attack. […] The causes of SCAD are unclear. SCAD mainly affects young, healthy people who have few or none of the typical risks for heart disease, such as diabetes, smoking, high cholesterol or obesity. […] Common factors and potential triggers for SCAD include: Being female SCAD tends to affect more women than men, Pregnancy and giving birth SCAD can occur in the first few weeks after delivery, Blood vessel conditions Fibromuscular Dysplasia can weaken the artery walls, Intense exercise such as intense aerobics, heavy weight lifting, Intense emotional stress such as a sudden death in the family, marriage breakdown, or job loss, Inflammatory conditions such as lupus, Crohn disease, ulcerative colitis, rheumatoid arthritis, celiac disease, Connective tissue disorders such as Marfan syndrome, Recreational drugs such as cocaine and amphetamines, Intense hormonal therapy. […] The treatment for SCAD depends on the size and the location of the tear. The goal of treatment is to restore blood flow to the heart and let the torn blood vessel heal on its own. Medication is often the preferred treatment for SCAD, as it is less invasive than surgery.

• #66 Spontaneous coronary artery dissection (SCAD) | Heart and Stroke Foundation

  https://www.heartandstroke.ca/heart-disease/conditions/spontaneous-coronary-artery-dissection

  Spontaneous Coronary Artery Dissection (SCAD) is a tear in an artery wall in your heart that allows blood to build up in the space between the layers of your artery wall. This leads to a reduction or blockage of blood flow to your heart, which causes damage to your heart muscle and affects your heart rhythm. Reduced blood flow could cause a heart attack or cardiac arrest (cardiopulmonary arrest). […] The cause of SCAD is still unknown. It is believed that it starts with your artery wall weakening. Possible causes of weakened artery walls are: fibromuscular dysplasia, genetics, multiple pregnancies, connective tissue disorders, systemic inflammations (like Crohns disease), hormonal changes/therapy, cocaine use. […] SCAD can also be triggered by highly emotional events (death of loved one, job loss, breakdown of marriage) or physical stresses (giving birth, weight lifting, intensive workout, straining bowel movement, coughing, retching/vomiting). In a recent study, more than half of patients experienced an emotionally or physically stressful event around the time of their SCAD.

• #67 Spontaneous coronary artery dissection causes – wikidoc

  https://www.wikidoc.org/index.php/Spontaneous_coronary_artery_dissection_causes

  The association between FMD and SCAD has been well described. The biological proof of causation has been supported by histopathologic reports. The presence of FMD may weaken the artery architecture and lead to aneurysm formation or coronary dissection. […] Both TCM and SCAD affect predominantly women and may be precipitated by emotional stress or strenuous exercise associated with sympathetic discharge. Numerous reports have described the concurrence of TCM and SCAD. In the setting of TCM, vigorous contraction of the left ventricular base in conjunction with the adjacent akinetic/dyskinetic segments could form a prerequisite anatomic/functional substrate for the causation of SCAD. The coronary dissection plane may develop as a result of excessive movement of the epicardial vessels and increased shear stress on the vessel wall at the hinge point between the hyperdynamic and dyskinetic/akinetic myocardium. Another plausible mechanism is that elevated catecholamine concentrations in TCM may cause epicardial coronary vasoconstriction and/or spasm, which in turn leads to increased arterial shear stress and subsequent intimal tear or disruption of vasa vasorum. The post-ischemic myocardial stunning associated with SCAD could lead to TCM, thus forming the TCM begets SCAD, and SCAD begets TCM vicious cycle.

• #68 Spontaneous coronary artery dissection causes – wikidoc

  https://www.wikidoc.org/index.php/Spontaneous_coronary_artery_dissection_causes

  The exact etiology of spontaneous coronary artery dissection remains elusive; however, fibromuscular dysplasia and takotsubo cardiomyopathy have been considered as the potential cause of spontaneous coronary artery dissection. The underlying causes associated with SCAD include emotional stress, physical stress such as extreme valsalva maneuver, retching, vomiting, coughing, isometric exercise, history of using stimulant medications or illicit drugs, pregnancy, and connective tissue disorders. […] Common causes associated with spontaneous coronary artery dissection (SCAD) include: Emotional stress, Physical stress such as extreme valsalva maneuver, retching, vomiting, coughing, isometric exercise, Using stimulant medications, illicit drugs, Hormonal triggers such as pregnancy, Inflammatory disorders such as systemic lupus erythematosus, sarcoidosis, Crohn’s disease, Ulcerative colitis, celiac disease, fibromuscular dysplasia (FMD), takotsubo cardiomyopathy (TCM), Connective tissue disorders such as vascular EhlersDanlos syndrome, marfans syndrome, LoeysDietz syndrome, cystic medial necrosis, systemic lupus erythematosus, polyarteritis nodosa, sarcoidosis, churg-Strauss syndrome, wegener’s granulomatosis, rheumatoid arthritis, giant cell arthritis.

• #69 Spontaneous Coronary Artery Dissection | University of Ottawa Heart Institute

  https://www.ottawaheart.ca/heart-condition/spontaneous-coronary-artery-dissection

  Diseases that cause inflammation of the blood vessels: Conditions such as lupus and polyarteritis nodosa have been associated with SCAD. […] Inherited connective tissue diseases: Genetic conditions that cause problems with the body’s connective tissues, such as Ehlers-Danlos syndrome (vascular EDS) and Marfan syndrome, have been found to occur in some people with SCAD. […] Very high blood pressure: Untreated, severely high blood pressure is associated with SCAD. […] Cocaine use.

• #70

  https://link.springer.com/article/10.1007/s12471-019-1235-4

  It is believed that female sex hormones, especially progesterone, which are high in premenopausal women and during pregnancy, influence the integrity of arterial walls. […] Although uncommon, mixed connective tissue disorders (MCTD) predispose for SCAD, since these are associated with arterial fragility and vascular dissection. […] Systemic inflammatory disorders associated with SCAD are systemic lupus erythematosus, Crohns disease, ulcerative colitis, rheumatoid arthritis and coeliac disease.

• #71

  https://link.springer.com/article/10.1007/s12471-019-1235-4

  It is believed that female sex hormones, especially progesterone, which are high in premenopausal women and during pregnancy, influence the integrity of arterial walls. […] Although uncommon, mixed connective tissue disorders (MCTD) predispose for SCAD, since these are associated with arterial fragility and vascular dissection. […] Systemic inflammatory disorders associated with SCAD are systemic lupus erythematosus, Crohns disease, ulcerative colitis, rheumatoid arthritis and coeliac disease.

• #72 Spontaneous coronary artery dissection causes – wikidoc

  https://www.wikidoc.org/index.php/Spontaneous_coronary_artery_dissection_causes

  The exact etiology of spontaneous coronary artery dissection remains elusive; however, fibromuscular dysplasia and takotsubo cardiomyopathy have been considered as the potential cause of spontaneous coronary artery dissection. The underlying causes associated with SCAD include emotional stress, physical stress such as extreme valsalva maneuver, retching, vomiting, coughing, isometric exercise, history of using stimulant medications or illicit drugs, pregnancy, and connective tissue disorders. […] Common causes associated with spontaneous coronary artery dissection (SCAD) include: Emotional stress, Physical stress such as extreme valsalva maneuver, retching, vomiting, coughing, isometric exercise, Using stimulant medications, illicit drugs, Hormonal triggers such as pregnancy, Inflammatory disorders such as systemic lupus erythematosus, sarcoidosis, Crohn’s disease, Ulcerative colitis, celiac disease, fibromuscular dysplasia (FMD), takotsubo cardiomyopathy (TCM), Connective tissue disorders such as vascular EhlersDanlos syndrome, marfans syndrome, LoeysDietz syndrome, cystic medial necrosis, systemic lupus erythematosus, polyarteritis nodosa, sarcoidosis, churg-Strauss syndrome, wegener’s granulomatosis, rheumatoid arthritis, giant cell arthritis.

• #73 Spontaneous coronary artery dissection causes – wikidoc

  https://www.wikidoc.org/index.php/Spontaneous_coronary_artery_dissection_causes

  The exact etiology of spontaneous coronary artery dissection remains elusive; however, fibromuscular dysplasia and takotsubo cardiomyopathy have been considered as the potential cause of spontaneous coronary artery dissection. The underlying causes associated with SCAD include emotional stress, physical stress such as extreme valsalva maneuver, retching, vomiting, coughing, isometric exercise, history of using stimulant medications or illicit drugs, pregnancy, and connective tissue disorders. […] Common causes associated with spontaneous coronary artery dissection (SCAD) include: Emotional stress, Physical stress such as extreme valsalva maneuver, retching, vomiting, coughing, isometric exercise, Using stimulant medications, illicit drugs, Hormonal triggers such as pregnancy, Inflammatory disorders such as systemic lupus erythematosus, sarcoidosis, Crohn’s disease, Ulcerative colitis, celiac disease, fibromuscular dysplasia (FMD), takotsubo cardiomyopathy (TCM), Connective tissue disorders such as vascular EhlersDanlos syndrome, marfans syndrome, LoeysDietz syndrome, cystic medial necrosis, systemic lupus erythematosus, polyarteritis nodosa, sarcoidosis, churg-Strauss syndrome, wegener’s granulomatosis, rheumatoid arthritis, giant cell arthritis.

• #74

  https://link.springer.com/article/10.1007/s11886-023-02019-w

  Spontaneous coronary artery dissection (SCAD) is an increasingly recognized etiology for acute coronary syndrome (ACS) in the young, accounting for 14% of all ACS cases. While SCAD has been reported in both sexes, the vast majority of cases occur in middle-aged women from ages 44 to 53 years old in the absence of traditional cardiovascular risk factors. While prior population studies report SCAD as a rare etiology for myocardial infarction, recent studies demonstrate SCAD as the cause of 35% of all ACS events in women under the age of 50 years old. […] Described triggers for SCAD include stress (physical or psychological), use of illicit substances, underlying arteriopathies, and hormonal factors such as pregnancy. Additional infrequent, but important, triggers include inflammatory disorders such as inflammatory bowel disease or systemic vasculitides such as Takayasu arteritis.

• #75 Understanding Spontaneous Coronary Artery Dissection | Banner

  https://www.bannerhealth.com/services/heart/heart-disease/scad

  Experts don’t know exactly what causes SCAD, but some factors can trigger the condition: […] Hormone fluctuations: The hormonal changes that happen during and after pregnancy may weaken the walls of the arteries and make them more likely to tear. […] Physical stress: Strenuous exercise like weightlifting or extreme yoga poses or stressors like coughing or vomiting have been linked to SCAD. […] Connective tissue disorders: Conditions like Marfan syndrome or Ehlers-Danlos syndrome may weaken the arterys walls and make them more likely to tear. […] Inflammatory conditions: Autoimmune diseases like lupus or multiple sclerosis or inflammation of the arteries (arteritis) may make SCAD more likely. […] Migraines and emotional stress: Migraines may be linked to SCAD. And sudden stressful events or long-lasting periods of stress could also be triggers.

• #76 Spontaneous coronary artery dissection, a commonly overlooked etiology of acute coronary syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7427437/

  Spontaneous coronary artery dissection (SCAD) is a type of non-atherosclerotic coronary artery disease, initially thought to be uncommon but is now being increasingly recognized as a cause of acute coronary syndrome in females. […] The risk factors for SCAD include female sex, young age, extreme emotional stress, exertion, pregnancy, fibromuscular dysplasia and it is also associated with inherited connective tissue diseases such as Marfan syndrome, Ehlers-Danlos, and Loeys-Dietz syndrome. […] The exact prevalence of SCAD remains unclear and reported prevalence ranges from 0.1% to 25%. […] The risk factors of SCAD have been poorly elaborated till date. Initially, SCAD was thought to be only associated with hormonal and hemodynamic changes due to pregnancy and postpartum state but risk factors now include female sex, young age, extreme emotional stress, exertion, and fibromuscular dysplasia.

• #77 Spontaneous coronary artery dissection (SCAD) | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20188640/

  Spontaneous coronary artery dissection is an emergency condition that occurs when a tear forms in a wall of a heart artery. Spontaneous coronary artery dissection also is called SCAD. […] The cause of spontaneous coronary artery dissection is unknown. […] SCAD can happen after extreme stress. This includes intense physical exercise and severe emotional distress. […] Genetic conditions affecting connective tissue. Ehlers-Danlos and Marfan syndromes have been found to occur in people who have had SCAD. […] Very high blood pressure. Severe high blood pressure can raise the risk of SCAD. […] Illegal drug use. Using cocaine or other illegal drugs might increase the risk of SCAD.

• #78 2. Risk Factors for SCAD – SCAD Alliance

  https://scadalliance.org/scad-warrior-app/risk-factors-for-scad-2/

  Inherited connective tissue diseases. Genetic diseases that cause problems with the body’s connective tissues, such as vascular Ehlers-Danlos syndrome and Marfan syndrome, have been found in people with SCAD. […] Extreme physical exercise. People who recently participated in extreme or intense exercises may be at higher risk for SCAD. […] Severe emotional stress. Someone who has experienced significant emotional stress, such as a sudden death in the family, relationship conflicts or work stress may be at higher risk for SCAD. […] Very high blood pressure. Having untreated, severe high blood pressure can be associated with SCAD. […] Illegal drug use. Using cocaine or other illegal drugs may increase the risk of SCAD.

• #79 Understanding Spontaneous Coronary Artery Dissection | Banner

  https://www.bannerhealth.com/services/heart/heart-disease/scad

  Substance abuse: Using cocaine or other drugs may raise your risk of SCAD. […] Uncontrolled hypertension: High blood pressure thats not well managed puts strain on the blood vessel walls. […] SCAD can affect anyone, but it’s most often found in women under age 50. Less than 10% of SCAD cases occur in males. […] If youve had SCAD in the past, youre more likely to have it again. […] Your risk may be higher if you have a family history of SCAD. […] SCAD is more common in women under age 50, who are less likely to have risk factors like high cholesterol or high blood pressure. […] SCAD isn’t caused by plaque buildup in the arteries. […] Sometimes, SCAD gets better without treatment. Heart attacks usually cause some long-lasting damage. […] SCAD patients are usually treated with medication and certain procedures.

• #80 What is spontaneous coronary artery dissection (SCAD)? – Sunnybrook Hospital

  https://sunnybrook.ca/content/?page=what-is-scad

  Although up to 10% of patients with SCAD were taking hormonal therapy, so far there is no conclusive evidence that hormonal therapy causes SCAD or increases the risk of SCAD recurrence. […] Very few genes have been identified that have an association with SCAD. […] SCAD patients have lower rates of traditional cardiovascular risk factors. […] Patients with SCAD report higher rates of emotional and physical stressors.

• #81 Spontaneous coronary artery dissection (SCAD) | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20188640/

  Spontaneous coronary artery dissection is an emergency condition that occurs when a tear forms in a wall of a heart artery. Spontaneous coronary artery dissection also is called SCAD. […] The cause of spontaneous coronary artery dissection is unknown. […] SCAD can happen after extreme stress. This includes intense physical exercise and severe emotional distress. […] Genetic conditions affecting connective tissue. Ehlers-Danlos and Marfan syndromes have been found to occur in people who have had SCAD. […] Very high blood pressure. Severe high blood pressure can raise the risk of SCAD. […] Illegal drug use. Using cocaine or other illegal drugs might increase the risk of SCAD.

• #82 Spontaneous Coronary Artery Dissection | University of Ottawa Heart Institute

  https://www.ottawaheart.ca/heart-condition/spontaneous-coronary-artery-dissection

  Diseases that cause inflammation of the blood vessels: Conditions such as lupus and polyarteritis nodosa have been associated with SCAD. […] Inherited connective tissue diseases: Genetic conditions that cause problems with the body’s connective tissues, such as Ehlers-Danlos syndrome (vascular EDS) and Marfan syndrome, have been found to occur in some people with SCAD. […] Very high blood pressure: Untreated, severely high blood pressure is associated with SCAD. […] Cocaine use.

• #83 Understanding Spontaneous Coronary Artery Dissection | Banner

  https://www.bannerhealth.com/services/heart/heart-disease/scad

  Substance abuse: Using cocaine or other drugs may raise your risk of SCAD. […] Uncontrolled hypertension: High blood pressure thats not well managed puts strain on the blood vessel walls. […] SCAD can affect anyone, but it’s most often found in women under age 50. Less than 10% of SCAD cases occur in males. […] If youve had SCAD in the past, youre more likely to have it again. […] Your risk may be higher if you have a family history of SCAD. […] SCAD is more common in women under age 50, who are less likely to have risk factors like high cholesterol or high blood pressure. […] SCAD isn’t caused by plaque buildup in the arteries. […] Sometimes, SCAD gets better without treatment. Heart attacks usually cause some long-lasting damage. […] SCAD patients are usually treated with medication and certain procedures.

• #84 Spontaneous coronary artery dissection causes – wikidoc

  https://www.wikidoc.org/index.php/Spontaneous_coronary_artery_dissection_causes

  The association between FMD and SCAD has been well described. The biological proof of causation has been supported by histopathologic reports. The presence of FMD may weaken the artery architecture and lead to aneurysm formation or coronary dissection. […] Both TCM and SCAD affect predominantly women and may be precipitated by emotional stress or strenuous exercise associated with sympathetic discharge. Numerous reports have described the concurrence of TCM and SCAD. In the setting of TCM, vigorous contraction of the left ventricular base in conjunction with the adjacent akinetic/dyskinetic segments could form a prerequisite anatomic/functional substrate for the causation of SCAD. The coronary dissection plane may develop as a result of excessive movement of the epicardial vessels and increased shear stress on the vessel wall at the hinge point between the hyperdynamic and dyskinetic/akinetic myocardium. Another plausible mechanism is that elevated catecholamine concentrations in TCM may cause epicardial coronary vasoconstriction and/or spasm, which in turn leads to increased arterial shear stress and subsequent intimal tear or disruption of vasa vasorum. The post-ischemic myocardial stunning associated with SCAD could lead to TCM, thus forming the TCM begets SCAD, and SCAD begets TCM vicious cycle.

• #85 Spontaneous coronary artery dissection causes – wikidoc

  https://www.wikidoc.org/index.php/Spontaneous_coronary_artery_dissection_causes

  The association between FMD and SCAD has been well described. The biological proof of causation has been supported by histopathologic reports. The presence of FMD may weaken the artery architecture and lead to aneurysm formation or coronary dissection. […] Both TCM and SCAD affect predominantly women and may be precipitated by emotional stress or strenuous exercise associated with sympathetic discharge. Numerous reports have described the concurrence of TCM and SCAD. In the setting of TCM, vigorous contraction of the left ventricular base in conjunction with the adjacent akinetic/dyskinetic segments could form a prerequisite anatomic/functional substrate for the causation of SCAD. The coronary dissection plane may develop as a result of excessive movement of the epicardial vessels and increased shear stress on the vessel wall at the hinge point between the hyperdynamic and dyskinetic/akinetic myocardium. Another plausible mechanism is that elevated catecholamine concentrations in TCM may cause epicardial coronary vasoconstriction and/or spasm, which in turn leads to increased arterial shear stress and subsequent intimal tear or disruption of vasa vasorum. The post-ischemic myocardial stunning associated with SCAD could lead to TCM, thus forming the TCM begets SCAD, and SCAD begets TCM vicious cycle.

• #86 Spontaneous coronary artery dissection causes – wikidoc

  https://www.wikidoc.org/index.php/Spontaneous_coronary_artery_dissection_causes

  The association between FMD and SCAD has been well described. The biological proof of causation has been supported by histopathologic reports. The presence of FMD may weaken the artery architecture and lead to aneurysm formation or coronary dissection. […] Both TCM and SCAD affect predominantly women and may be precipitated by emotional stress or strenuous exercise associated with sympathetic discharge. Numerous reports have described the concurrence of TCM and SCAD. In the setting of TCM, vigorous contraction of the left ventricular base in conjunction with the adjacent akinetic/dyskinetic segments could form a prerequisite anatomic/functional substrate for the causation of SCAD. The coronary dissection plane may develop as a result of excessive movement of the epicardial vessels and increased shear stress on the vessel wall at the hinge point between the hyperdynamic and dyskinetic/akinetic myocardium. Another plausible mechanism is that elevated catecholamine concentrations in TCM may cause epicardial coronary vasoconstriction and/or spasm, which in turn leads to increased arterial shear stress and subsequent intimal tear or disruption of vasa vasorum. The post-ischemic myocardial stunning associated with SCAD could lead to TCM, thus forming the TCM begets SCAD, and SCAD begets TCM vicious cycle.

• #87 Understanding Spontaneous Coronary Artery Dissection | Banner

  https://www.bannerhealth.com/services/heart/heart-disease/scad

  Experts don’t know exactly what causes SCAD, but some factors can trigger the condition: […] Hormone fluctuations: The hormonal changes that happen during and after pregnancy may weaken the walls of the arteries and make them more likely to tear. […] Physical stress: Strenuous exercise like weightlifting or extreme yoga poses or stressors like coughing or vomiting have been linked to SCAD. […] Connective tissue disorders: Conditions like Marfan syndrome or Ehlers-Danlos syndrome may weaken the arterys walls and make them more likely to tear. […] Inflammatory conditions: Autoimmune diseases like lupus or multiple sclerosis or inflammation of the arteries (arteritis) may make SCAD more likely. […] Migraines and emotional stress: Migraines may be linked to SCAD. And sudden stressful events or long-lasting periods of stress could also be triggers.

• #88 The Relationship Between Migraine and SCAD

  https://www.migrainedisorders.org/the-relationship-between-migraine-and-scad/

  SCAD is more likely to occur in the last trimester of pregnancy or during the postpartum period and is the most common cause of pregnancy related heart attacks. The stress of childbirth can result in SCAD through an unknown etiology. Hormonal therapy can also increase the incidence of SCAD for unknown reasons. […] The associations between SCAD and migraine are unknown but risk factors may include blood vessel abnormalities, hormonal fluctuations, depression and more. The underlying physiologies among both conditions are unknown. Although those with certain types of migraine have an increased risk of heart attack and stroke, it is unclear if migraine can predispose someone to SCAD.

• #89

  https://continentalhospitals.com/diseases/spontaneous-coronary-artery-dissection/

  Abnormalities in the structure of the coronary arteries, such as tortuosity (twisting) or aneurysms (ballooning), may predispose individuals to SCAD. […] FMD is a condition characterized by abnormal cell development in the walls of arteries, including the coronary arteries. It is considered a significant risk factor for SCAD. […] While most cases of SCAD occur sporadically, there is evidence to suggest that there may be a genetic component to the condition. Family history of SCAD or other cardiovascular disorders may increase an individual’s risk. […] Emotional stress or extreme emotional states have been reported as potential triggers for SCAD episodes in some individuals. […] Inflammation of the blood vessels, whether due to autoimmune conditions or other factors, may contribute to the weakening of arterial walls and increase the risk of SCAD.

• #90 Spontaneous Coronary Artery Dissection (SCAD)

  https://my.clevelandclinic.org/health/diseases/17503-spontaneous-coronary-artery-dissection-scad

  In rare instances, the force of severe vomiting or coughing may cause the artery wall to tear. A traumatic accident or a medical procedure like a cardiac catheterization can cause a coronary artery dissection. This type of tear has a known cause. […] People with certain conditions may be more prone to coronary artery dissection. These conditions include connective tissue diseases like Marfan syndrome, dangerously high blood pressure, fibromuscular dysplasia (FMD), hypothyroidism, inflammatory diseases like lupus, multiple sclerosis (MS) and sarcoidosis, and substance use disorder. […] SCAD can be life-threatening, claiming the lives of up to 5% of people who develop it. An artery tear increases your risk for chronic angina, disease recurrence, and heart inflammation. […] Spontaneous coronary artery dissection (SCAD) causes heart attack-like symptoms among people who are at low risk for heart problems. Females are most at risk.

• #91 Spontaneous coronary artery dissection: Principles of management | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/88/11/623

  Spontaneous coronary artery dissection (SCAD) is an acute noniatrogenic tear in the coronary arterial wall, leading to disruption of coronary blood flow and myocardial infarction. […] SCAD is primarily managed medically in clinically stable patients. […] A number of conditions have been associated with SCAD, most notably fibromuscular dysplasia, and less commonly chronic systemic inflammatory disease, connective-tissue disorders, pregnancy, and hypothyroidism. […] Despite these often poor outcomes, revascularization procedures may be appropriate in patients with the following high-risk features: left main coronary artery dissection, ongoing ischemia, thrombolysis in Myocardial Infarction (TIMI) grade 01 flow in a proximal vessel, hemodynamic instability, refractory arrhythmia. […] In line with contemporary ACS guidelines, anticoagulation is often appropriately initiated before SCAD is diagnosed.

• #92 Spontaneous Coronary Artery Dissection (SCAD)

  https://my.clevelandclinic.org/health/diseases/17503-spontaneous-coronary-artery-dissection-scad

  In rare instances, the force of severe vomiting or coughing may cause the artery wall to tear. A traumatic accident or a medical procedure like a cardiac catheterization can cause a coronary artery dissection. This type of tear has a known cause. […] People with certain conditions may be more prone to coronary artery dissection. These conditions include connective tissue diseases like Marfan syndrome, dangerously high blood pressure, fibromuscular dysplasia (FMD), hypothyroidism, inflammatory diseases like lupus, multiple sclerosis (MS) and sarcoidosis, and substance use disorder. […] SCAD can be life-threatening, claiming the lives of up to 5% of people who develop it. An artery tear increases your risk for chronic angina, disease recurrence, and heart inflammation. […] Spontaneous coronary artery dissection (SCAD) causes heart attack-like symptoms among people who are at low risk for heart problems. Females are most at risk.

• #93 Understanding Spontaneous Coronary Artery Dissection | Banner

  https://www.bannerhealth.com/services/heart/heart-disease/scad

  Experts don’t know exactly what causes SCAD, but some factors can trigger the condition: […] Hormone fluctuations: The hormonal changes that happen during and after pregnancy may weaken the walls of the arteries and make them more likely to tear. […] Physical stress: Strenuous exercise like weightlifting or extreme yoga poses or stressors like coughing or vomiting have been linked to SCAD. […] Connective tissue disorders: Conditions like Marfan syndrome or Ehlers-Danlos syndrome may weaken the arterys walls and make them more likely to tear. […] Inflammatory conditions: Autoimmune diseases like lupus or multiple sclerosis or inflammation of the arteries (arteritis) may make SCAD more likely. […] Migraines and emotional stress: Migraines may be linked to SCAD. And sudden stressful events or long-lasting periods of stress could also be triggers.

• #94

  https://link.springer.com/article/10.1007/s12471-019-1235-4

  Spontaneous coronary artery dissection (SCAD) represents around 25% of cases of acute coronary syndromes (ACS) in women aged 4065 years who have few or no traditional cardiovascular risk factors. […] It is estimated that up to 25% of all ACS in this age group are caused by SCAD, although the diagnosis is often missed. […] SCAD is defined as a spontaneous tear in the coronary arterial wall due to non-atherosclerotic and non-iatrogenic causes. […] The underlying pathophysiology of SCAD is multifactorial, related to underlying arteriopathies, inflammation, hormonal factors and mixed connective tissue diseases, whereas the acute event is often preceded by emotional or physical triggers. […] Predisposing factors which are associated with SCAD are fibromuscular dysplasia (FMD), female gender, pregnancy-related factors, possibly hormonal therapy, mixed connective tissue disorders and inflammatory disorders.

• #95 Spontaneous coronary artery dissection: a clinically oriented narrative review | npj Cardiovascular Health

  https://www.nature.com/articles/s44325-024-00004-y

  The observation that SCAD mostly affects young women, and that SCAD is the most common cause of pregnancy-associated MI suggest a role of female hormones in SCAD susceptibility. […] Structural weakness in the arterial wall is a predisposing risk factor for SCAD. […] Multiple arteriopathies have been reported in SCAD cases with the most common one being fibromuscular dysplasia (FMD). […] Rare instances of familial cases of SCAD, including in identical twins, have also been reported, suggesting genetic susceptibility. […] SCAD has also been observed in cases of rare inherited vascular diseases, such as Ehlers-Danlos syndrome, Marfan syndrome, and Loey-Dietz syndrome. […] In a systematic review of n=4206 patients with SCAD, beta-blockers were found to be significantly associated with a reduced risk of SCAD recurrence after adjustment for confounders.

• #96 Spontaneous Coronary Artery Dissection: An up to Date

  https://clinmedjournals.org/articles/iaim/international-archives-of-internal-medicine-iaim-3-011.php?jid=iaim

  Spontaneous dissection of the coronary artery (SCAD) is an uncommon cause of acute coronary syndrome (ACS) and is defined as a dissection of the coronary artery not associated with an atherosclerotic process, plaque rupture and/or thrombus formation and, by definition, not iatrogenic. […] Two main theories of how a spontaneous dissection develops have been described, the first one suggests that primum movens is the formation of an interruption in the arterial wall (intimal tear), which causes blood to come out of the true lumen to create a false lumen. The second theory predicts that primum movens is a spontaneous hemorrhage from the vasa vasorum that starts the dissection process. […] SCAD is a multifactorial disease, with a poor predominance of traditional risk factors. Predisposing factors are female gender, pregnancy, age < 50 years, female sex hormones, other arteriopathies, such as fibromuscular dysplasia (FMD) that represents the most commonly extracoronary arterial disease associated. [...] Probable triggers of SCAD, in a predisposing patient, are emotional/physical stress, intense isometric exercise, and weightlifting.

• #97 Spontaneous Coronary Artery Dissection in Clinical Practice: Pathophysiology and Therapeutic Approaches

  https://www.mdpi.com/1648-9144/60/2/217

  The genetic substrate in SCAD pathogenesis is complex, polygenic, and not yet completely understood. Both rare and common disease-associated variants have been found in several genes, which are commonly caused by single nucleotide polymorphisms (SNPs), insertions or deletions, structural variants, intronic variants, and/or short tandem repeat expansions. […] The SNP rs9349379 of the phosphatase and actin regulator 1 (PHACTR1) gene causes arterial wall pathologies, giving an increased risk not only of SCAD but also of spontaneous cervical artery dissection, migraine, and fibromuscular dysplasia. […] In conclusion, further analyses in larger cohorts are required in order to completely understand the genetic architecture of SCAD pathogenesis and to clearly define the overlap between SCAD, CTD, and vasculopathies.

• #98 SCAD Research, Inc Spontaneous Coronary Artery Dissection | What is SCAD

  https://scadresearch.org/about/

  The suspected associated conditions or potential triggers for SCAD include: Pregnancy or postpartum period, Fibromuscular dysplasia (FMD), Extreme physical exertion, Extreme emotional stress, Connective-tissue abnormalities and monogenetic mutations. […] While most individuals who experience SCAD are women, SCAD can occur in men too. […] Because the causes of Spontaneous Coronary Artery Dissection (SCAD) are unknown at this point, there is no scientifically validated way to reduce the risk of SCAD occurring. […] Research has noted a substantial rate of spontaneous vascular healing and suggests a role for conservative management in stable SCAD patients who have preserved coronary flow. […] SCAD can recur, so vigilance, evaluation of associated conditions, and staying up-to-date on emerging research is also important. Statins do not appear to prevent another SCAD heart attack and one study found more recurrence in those taking statins. […] While the SCAD Research Program at Mayo Clinic has identified familial cases of in Spontaneous Coronary Artery Dissection (SCAD), occurrence of SCAD in more than one family member appears to be very rare, accounting for only ~1-2% of total cases in the Mayo Clinic registry.

• #99 Spontaneous coronary artery dissection – BHF

  https://www.bhf.org.uk/informationsupport/conditions/spontaneous-coronary-artery-dissection

  Spontaneous coronary artery dissection (SCAD) is an emergency condition when a tear appears in the wall of a coronary artery, which supplies blood to your heart. […] SCAD is a rare heart condition that happens suddenly with no apparent warning. It is most common in women who are in their 40s and 50s, but can happen to anyone. The condition cant currently be predicted or prevented. […] Unfortunately we do not yet know a great deal about SCAD, or why it happens. It often strikes out of the blue, but unlike many cases of coronary heart disease (CHD), the condition doesnt appear to be preventable. […] What we do know is that: SCAD most commonly occurs in women between 45 and 53; many people with SCAD will have few or no traditional risk factors for heart and circulatory disease; at least 80% of those with SCAD are women; it can often occur during, or soon after, pregnancy.

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