SCAD-Spontaneous Healing Common with Conservative Treatment

SCAD (Spontaneous Coronary Artery Dissection) is a very rare condition in which either bleeding or tearing of the innermost layer of the wall of the artery is observed. It blocks the blood from traveling from the coronary artery to the heart muscles. It is responsible for the maximum number of heart attacks especially for women under the age of 50. This can cause permanent damage to tissues of heart muscles if not treated properly. The most common systems of SCAD (Spontaneous Coronary Artery Dissection) are chest pain, heart attack, and cardiac arrest. It may also result in death in some cases. The most common victims of this are young women who are pregnant or who have recently delivered a baby. Sometimes, intense exercise also puts a strain on the chest leading to this problem in both males as well as females. In some of the cases, it occurs without any identifiable cause. Most of the patients of SCAD (Spontaneous Coronary Artery Dissection) do not have the risk factors that are normally attached to problems like high blood pressure, cholesterol, diabetes as well as smoking. A study was conducted by Saber Hassen, MD of University British Columbia and It was observed that the average age of patients with SCAD is 51 years, out of the which, 88.5% are female and more than 75% of them has fibromuscular dysplasia.

SCAD is a Spontaneous Coronary Artery Dissection which is a cause of heart attack that takes place when blood flow decreases or stops in some part of the heart. The coronary arteries affected by SCAD heal spontaneously by repeated angiography and the majority get completely healed after thirty days from SCAD event. SCAD (Spontaneous Coronary Artery Dissection) can be diagnosed by performing various tests for finding out heart attacks and blood test is done to detect the damage of the blood.

Majority cases of SCAD (Spontaneous Coronary Artery Dissection) can be cured over a period of time with the help of conservative treatment. This analysis has been conducted with the help of patients who have undergone repeated coronary angiography. Out of a total of 156 patients with 182 lesions, more than 95% of the lesions of SCAD healed spontaneously with the help of conservative treatment. If the patient is not going through ischemia or critical anatomy or the hemodynamic instability is not present, SCAD (Spontaneous Coronary Artery Dissection) can be healed with the help of conservative treatment.

The spontaneous healing technique is defined on the basis of three parameters –

• An improvement in the severity of stenosis from the event of the index.
• The residual diameter stenosis is less than 50%.
• The grade 3 flow of TIMI.

The conservative treatment helps avoid the use of instrumentation of the coronary artery, i.e., no wiring, stenting, or ballooning. This strategy is usually confusing for most of the patients as they are informed about the heart attack and not the conventional blockage and would not be getting any stent or surgery.

The first and initial treatment includes an increased amount of fiber as well as the fluid intake, sitz bath, stool softeners, and topical analgesics. Doctors may order topical nitrates like glyceryl trinitrate that can cause local vasodilation. This drug helps increase the blood flow to the area required. The topical calcium channel blockers that help relax the vascular smooth muscle. According to some of the reports, zinc preparation is also effective in treating anal fissures. These medications are readymade and suitable for application but only after consulting with a doctor or pharmacist. But if the fissure does not respond positively to the conservative treatment, the doctor may give an injection of botulinum toxin into the anal sphincter. This can sometimes heal up to 62% of fissures and the recurrence rate is just 6%.

Before opting up for severing treatment procedures, conservative treatment for SCAD is preferred by most of the doctors.

Women are generally more prone to SCAD (Spontaneous Coronary Artery Dissection) than men, especially during the time of pregnancy or soon after delivering the baby.

• Hardcore physical exercise.
• Intense emotional stress.
• High blood pressure.

Some of the inherited genetic conditions like Marfan’s syndrome, Ehlers Danlos Syndrome, and other related tissue diseases.

Use of illicit drugs such as cocaine, methamphetamines as well as the stimulant supplements available over-the-counter also causes SCAD (Spontaneous Coronary Artery Dissection).

The symptoms of SCAD (Spontaneous Coronary Artery Dissection) are same as that of a heart attack –

• An uncomfortable pressure, fullness, squeezing pain in the chest, especially the central region that lasts for more than a few minutes.
• The pain can reach shoulders, neck, or arms.
• Lightheadedness, fainting, sweat, nausea, vomiting and shortness of breath.

There are several treatment ways which are done to restore the blood flow in to the heart. For some of the people, healing will occur naturally while for some people treatment can be done by opening the artery with the help of a balloon or stent or surgically bypassing the artery. The treatment of the individual varies depending on the signs or symptoms of individual person. Some people may get relief by taking medicines while for some people who are having the problem of chest pain and blood pressure issues need other treatments to cure SCAD (Spontaneous Coronary Artery Dissection).

• Treatment By Placing A Stent To Hold The Artery Open- It is done if the blood flow is blocked to the heart, and medicines are not helpful in controlling the chest pain then the stent (mesh tube) is required to hold the artery open.
• Treatment By Surgically Bypassing The Artery- If the stent does not work or have more than one tear in the artery then the new passage for the blood is created to reach the heart.
• Medications- Certain medicines are required for curing SCAD perfectly and the prescription given by the doctor should be followed strictly to live healthy life. Blood thinning drugs are taken by individual suffering from SCAD problem so that the risk of clotting in the torn artery is reduced. Blood pressure drugs are taken to lower the heart’s demand for blood. These drugs are taken for treating high blood pressure in individual having the problem of SCAD. Also, some people have high cholesterol level so to control it certain medicines are taken to get relief from it.

After going through the treatment of SCAD (Spontaneous Coronary Artery Dissection), one should follow a strict diet and do regular exercise to prevent certain other health problems. The people undergoing cardiac rehabilitation needs regular exercise and education to help recover from a serious heart condition. This also includes nutritional counseling, emotional support, positive mind set and education. Some people often have this spontaneous coronary artery dissection as heredity from parental source.

Therefore, one should also undergo genetic testing and review the family medical history to check whether it comes from heredity or not. If women have this spontaneous coronary artery dissection, then pregnancy should be avoided. To recover fast from this problem, proper sleep is required. Healthy diet full of fruits and green vegetables should be taken. To cope with stress, one should listen to music and write down the thoughts that come in mind which keeps mind healthy. One should spend time with friends and family and discuss the concerns which help the individual to cope with his/her condition.

So, from this we conclude that there are many different alternate treatment methods for the people to get relief from spontaneous coronary artery dissection. One should think of the positive thoughts in mind, take regular medicines as prescribed by the doctor, take healthy food and sleep well, read good motivational books which helps in recovering from SCAD (Spontaneous Coronary Artery Dissection) naturally.

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