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Spontaneous Coronary Artery Dissection (SCAD)


Wagers, Tina Pittman, MSW, PsyD; Stevens, Courtney J., PhD; Ross, Kaitlin V., MSEd; Leon, Katherine Kelly, MS; Masters, Kevin S., PhD

Journal of Cardiopulmonary Rehabilitation and Prevention: November 2018 - Volume 38 - Issue 6 - p 374–379
doi: 10.1097/HCR.0000000000000330
Cardiac Rehabilitation

Purpose: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic type of acute myocardial infarction that primarily affects young, healthy women without typical risk factors for heart disease. Few investigations have examined psychosocial variables in this population and none have looked at patient perceptions of the experience and stresses associated with having a SCAD event or the resources currently available to SCAD survivors. This investigation describes survivors' subjective experiences of SCAD. Participants also provided information about types and helpfulness of resources available to them post-SCAD, including cardiac rehabilitation.

Methods: Participants were recruited online and completed a one-time questionnaire.

Results: Participants (n = 409) completed a questionnaire concerning their experiences with their SCAD event in the 1 y and 2 wk prior to the SCAD event. Their responses reflected moderate to high perceptions of stress. Participants experienced the SCAD event as highly stressful and frightening and their heart health presents as a moderate-severe source of current, post-diagnosis stress. Spontaneous coronary artery dissection–based informational support was frequently rated as inadequate, whereas other supportive resources varied in their helpfulness and accessibility. Participants reported positive experiences in cardiac rehabilitation and strong interest in SCAD-specific, professionally led, online patient education and support groups.

Conclusions: This study is the largest to date investigation of SCAD survivors and their experiences in this understudied and perhaps underrecognized condition. Opportunities for researchers and providers to develop, tailor, and disseminate SCAD-specific interventions are discussed.

Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic type of acute myocardial infarction that primarily affects young, healthy women. This study reports on a survey of attitudes about psychosocial variables and resources in SCAD survivors (n = 409). Implications for cardiac rehabilitation providers delivering services to SCAD survivors are discussed.

Department of Psychology and Neuroscience, University of Colorado Boulder (Drs Wagers and Stevens); Graduate School of Professional Psychology, University of Denver, Denver, Colorado (Dr Ross); SCAD Alliance, Alexandria, Virginia (Ms Leon); and Department of Psychology, University of Colorado Denver (Dr Masters). Dr Stevens is now affiliated with the Dartmouth Centers for Health and Aging and the Department of Psychiatry at the Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.

Correspondence: Tina Pittman Wagers, MSW, PsyD, Department of Psychology and Neuroscience, University of Colorado Boulder, 345 UCB, Boulder, CO 80309 (

The authors declare no conflicts of interest.

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