The goal of treatment for SCAD is to restore blood flow to your heart. Sometimes, this healing will occur naturally. In others, doctors may have to restore blood flow by opening the artery with a balloon or stent. Bypass surgery may also be used.
The treatments most appropriate for you will depend on your condition, including the size and location of the tear in the artery, as well as any signs or symptoms you're experiencing. Whenever possible, doctors allow the damaged artery to heal on its own, rather than repairing it using invasive procedures.
For some people, medications may relieve the symptoms of SCAD. In these situations, it may be possible to be treated by medications alone. If chest pain or other symptoms persist, other treatments may be needed.
Placing a stent to hold the artery open
If SCAD has blocked blood flow to your heart or if medications don't control your chest pain, your doctor may recommend placing a tiny mesh tube (stent) inside your artery to hold it open. A stent can help restore blood flow to your heart.
To position the stent, doctors insert a long, thin tube (catheter) into an artery — usually in your leg or arm — and guide the tube to the arteries in your heart. X-rays are used to help the doctor see where to place the catheter.
A wire with a deflated balloon is passed through the catheter to the tear in the artery. The balloon is then inflated, expanding the stent against your artery walls. The stent is left in place to hold the artery open.
Surgery to bypass the damaged artery
If other treatments haven't worked or if you have more than one tear in an artery, your doctor may recommend surgery to create a new way for blood to reach your heart.
Coronary bypass surgery involves removing a blood vessel from another part of your body, such as your leg. That blood vessel is stitched into place so that it diverts blood flow around your damaged artery.
After SCAD, your doctor may recommend medications, including:
- Aspirin. Aspirin may help prevent cardiovascular disease problems after SCAD.
- Blood-thinning drugs. Drugs that reduce the number of blood-clotting platelets in your blood (anticoagulants) can reduce the risk of a clot forming in the torn artery.
- Blood pressure drugs. Drugs used to treat high blood pressure can lower your heart's demand for blood, reducing the pressure in your damaged artery. You may continue to take blood pressure drugs indefinitely to reduce the risk of another SCAD.
- Medications to control chest pain. These medications (nitrates and calcium channel blockers) can help treat chest pain you may experience after SCAD.
- Cholesterol drugs. People who have abnormal cholesterol levels and other risk factors may need to take medications to control their cholesterol levels.
After your treatment for SCAD, you'll need regular follow-up appointments with your doctor to monitor for any changes in your condition. Your doctor may also recommend other types of care to help you recover and to prevent other health problems. These may include:
- Undergoing cardiac rehabilitation. Cardiac rehabilitation is a customized program of exercise and education designed to help you recover from a serious heart condition. Cardiac rehabilitation often includes monitored exercise, nutritional counseling, emotional support and education.
- Reviewing your family medical history. Some inherited conditions, such as the connective tissue disease Marfan syndrome, have been found to occur in people who have had SCAD. Your doctor may refer you to a genetic counselor to review your family medical history and determine whether genetic testing may be appropriate for you.
- Looking for weaknesses in other blood vessels. Your doctor may recommend using CT angiography to look for weaknesses and abnormalities in other blood vessels, such as FMD.