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SCAD: The pregnancy-related heart attack women should know about

Lankenau Medical Center July 16, 2020 Heart Health

During pregnancy, you may not be thinking about your heart health. After all, your body is going through a myriad of physical changes and emotional ups and downs as you prepare for the arrival of a new baby. But recent reports from Good Morning America and Today are bringing attention to SCAD, a type of heart attack that’s affecting women—and largely during pregnancy. 

Short for spontaneous coronary artery dissection, SCAD refers to a type of heart attack that occurs as a result of a tear in the artery. (Traditional heart attacks occur when an artery is blocked, not torn.) While SCAD heart attacks can occur in men and women of any age, approximately one-third of all SCAD cases occur in women during pregnancy or the postpartum period.

Pregnancy and heart disease risk

The connection between a woman’s health during pregnancy and her heart disease risk has been well-documented. 

“Pre-eclampsia and gestational diabetes or gestational hypertension are all risk factors that occur during pregnancy and need to be taken into consideration when assessing a woman’s risk for heart disease,” says Kate Hawthorne, MD, a Lankenau Heart Institute cardiologist at Lankenau Medical Center, part of Main Line Health. 

Cardiac health of mothers during pregnancy has also been shown to affect their children; poor heart health can affect fetal growth and birthweight for babies and influence a child’s risk for congenital heart disease or other chronic diseases later in life.

What makes SCAD unique is that it can affect women who are otherwise healthy and don’t have the risk factors that are commonly associated with heart disease like high blood pressure and cholesterol, obesity, smoking or a family history of heart disease

The link between SCAD and pregnancy

As the awareness of SCAD grows in the medical community and among women, more research is needed to determine exactly what about pregnancy and the postpartum period put women at greater risk for this pregnancy-related heart attack. However, some research suggests that the physical and emotional stress of pregnancy and childbirth could be a factor.

“Intense physical exercise or stress has been shown to increase the risk of SCAD, which helps to explain why it occurs so frequently in women during pregnancy and after delivery, both of which are incredibly taxing on the body,” explains Dr. Hawthorne.

Genetic diseases (Marfan syndrome, vascular Ehlers-Danlos syndrome) and blood vessel conditions (lupus, fibromuscular dysplasia) have also been linked to increased SCAD risk so, if you’re planning to become pregnant and one of these conditions applies to you, consult with your Ob/Gyn. He or she may refer you to be under the care of a cardiologist with experience in caring for pregnant and postpartum women. 

Managing your risk for heart attack during pregnancy

If SCAD occurs in women who have no cardiac risk factors and are otherwise healthy, you might be wondering: What else can I do to manage SCAD risk? Isn’t a healthy lifestyle good enough? It is, says Dr. Hawthorne, but there are some additional steps you can take to manage your risk:

  • Find time to relax. This might seem impossible, especially if you’re balancing career, family and personal obligations, but it’s necessary. Pregnancy can be an emotional time for many women, and making time every day to unwind or de-stress is good for your health in many ways.
  • Exercise. Exercising during your pregnancy is safe and good for you, and can help keep those heart disease risk factors like gestational diabetes under control. But before you begin your routine, talk to your doctor to ensure your workout is safe to continue.
  • Manage your cholesterol and blood pressure. Your Ob/Gyn will help you keep track of these numbers, but keeping them low can reduce SCAD and heart disease risk.

Finally—and perhaps most importantly—you should remember to seek emergency care if you experience any of the common symptoms of heart attack. 

“Because SCAD occurs in women who are otherwise healthy, many of them dismiss symptoms like chest pain, shortness of breath, fatigue and dizziness and attribute them to pregnancy,” says Dr. Hawthorne. “If you’re experiencing these symptoms, you need to seek emergency medical attention immediately. Don’t second guess yourself or hesitate.”

If you have questions related to your heart health or would like more information about the Main Line Health Women’s Heart Initiative, our team of cardiologists and support groups, please call 484.476.3WHI (484.476.3944). Main Line Health is also a proud sponsor of the American Heart Association’s Go Red For Women campaign.

Main Line Health serves patients at hospitals and health centers throughout the western suburbs of Philadelphia. To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (225.5654) or use our secure online appointment request form.