Angina is a symptom of a problem with your heart muscle when it isn't getting enough oxygen-rich blood. It feels like pain, pressure, squeezing, or other uncomfortable feeling in your chest. The discomfort may also be felt in your shoulders, arms, neck, jaw, abdomen, or back. Some people have shortness of breath or fatigue (either with or without angina) when the heart muscled lacks enough oxygen.
Angiography and Cardiac Catheterization:
A special x-ray used to see if your coronary arteries are narrowed or blocked is called angiography. The image (angiogram) is made during a cardiac catheterization when the doctor inserts a tube through your artery and injects contrast dye to visualize any irregularity in your heart's blood flow.
Often recommended for MI patients because it thins the blood and prevents clots from forming.
These medications are often recommended for SCAD patients because they reduce blood pressure by blocking the effects of epinephrine or adrenaline. Keeping blood pressure down reduces stress in the coronary arteries. Many studies have demonstrated that beta blockers can decrease the likelihood of recurrent SCAD.
Connective Tissue Disorders:
There a few connective tissue disorders, like Ehlers-Danlos syndrome, Loeys-Dietz syndrome and Marfan’s syndrome, that are found in a small minority of SCAD patients. Connective tissues bind structures together, providing support for the body and organs, and can include tendons, ligaments, bone, cartilage, fat, blood and lymphatic fluid. Connective tissue is like “cellular glue” and connective tissue disorders impede proper functioning of those tissues.
Conservative Medical Management:
In most (but not all) cases of SCAD, conservative (as opposed to invasive) medical management is recommended, which includes several days of hospitalization and monitoring, as well as medications, like aspirin, beta-blockers and/or nitroglycerin.
Coronary Artery Bypass Grafting (CABG):
Grafting a blood vessel from another part of the body (like the chest, leg or arm) in order to repair a coronary artery that has been damaged, for example as a result of SCAD. Also, another piece of evidence that science and medicine are really cool.
Fibromuscular Dysplasia (FMD):
A condition that causes narrowing (stenosis) and enlargement (aneurysm) of arteries. Stenosis can impede blood flow. FMD can affect arteries around the heart, but patients with FMD often have the condition in other arteries, too, including those in the kidney and brain.
A condition in which a mutation to one or multiple genes creates a problematic physiological condition. Genetic studies related to SCAD are ongoing, but there is evidence that SCAD is genetically related to migraine headaches and FMD.
Major adverse coronary event (or MACE):
This is a broad term used in cardiovascular research that refers to any number of problematic cardiac events, including SCAD, but also including angina, heart failure or coronary events requiring hospitalization or intervention.
Most heart attacks are caused by atherosclerosis, which is a condition wherein cholesterol-filled plaque builds up inside of arteries, causing narrowing of the arteries leading sometimes to myocardial infarction (or MI). A nonatherosclerotic MI is NOT caused by plaque, but by something else, including a dissection of the vessel, like in SCAD. As a new SCAD survivor, you will be explaining this difference to people over and over again. Get used to it.
In this kind of ACS, an artery is partially blocked, and the heart is stressed and deprived of oxygen, but the ST elevation pattern will not show up on an EKG.
Percutaneous coronary intervention (PCI):
This is a type of minimally invasive procedure used to unblock arteries and restore blood flow, like stenting or balloon dilations. Because of the pathology sometimes found in SCAD patients’ coronary arteries (which I often describe thusly: “we have weird arteries”), PCI can sometimes be challenging to complete without causing damage from the procedure itself.
The period of time which is typically defined as encompassing the last month of pregnancy and the first few months after delivery.
Segment elevation MI (STEMI):
An acute coronary syndrome (ACS) with a completely blocked artery. When this occurs, there is a particular pattern on an EKG that will show up, which is referred to by EKG aficianados as an ST-elevation. If you are NOT an EKG aficionado, but a mere mortal, you can think of a STEMI as an event that involved a complete blockage of an artery.
Spontaneous Coronary Artery Dissection (SCAD):
SCAD happens when a tear or spontaneous hemorrhage happens inside of a coronary artery wall, which then forms a clot or obstruction, blocking the flow of blood through the artery. It is unrelated to atherosclerosis. Frequently, SCAD is related to an underlying condition that weakens the wall of the coronary artery, and additional factors (including, but not limited to, emotional or physical stress), may precipitate a tear.
Systemic inflammatory disease:
Chronic inflammatory systemic diseases (CIDs) like rheumatoid arthritis, systemic lupus erythematosus and multiple sclerosis, are maladaptations of the immune, nervous, endocrine or reproductive system wherein the body responds to a stressor or toxin with an inflammatory response. Short term inflammatory responses are useful as the body copes with a stressor, infection or toxin, but can become problematic if the response is prolonged or chronic.