Unexplained chest pain in women? Cardiologist explains why it could be SCAD and not a blocked artery

Causes of Spontaneous Coronary Artery Dissection (SCAD) in women: Hormonal fluctuations during pre- and peri-menopause can make arteries weaker and lead to heart attacks (Image: Pexels)

Heart attacks aren’t just something that happens to older men or women with high cholesterol. For many younger women in their 30s, 40s and early 50s, there’s a silent culprit that doctors are spotting more often: Spontaneous Coronary Artery Dissection, or SCAD.

Dr Mitesh Kumar F, Senior Consultant – Interventional Cardiology at Fortis Hospital, Bengaluru, tells Moneycontrol, “SCAD is often missed because it doesn’t follow the usual rules. Many young women with few risk factors end up in the emergency room with a heart attack, and it’s not caused by blocked arteries as most people think.”

Explaining SCAD, Dr Kumar says, it happens when a tear forms in the wall of a coronary artery, reducing blood flow to the heart. “Unlike the more familiar heart attacks caused by cholesterol build-up, SCAD is linked to fragile arteries, hormonal changes, connective tissue disorders, inflammation, or intense stress — emotional or physical.”

Also read | Symptoms of heart attack in women: Beware of chest pain, fatigue, cold sweat and more

Hormonal fluctuations during pre- and peri-menopause, he says, can make arteries weaker, and life’s pressures add another layer of risk. “Even women who eat well, exercise, and have no traditional heart problems can be vulnerable,” he warns.

Symptoms of Spontaneous Coronary Artery Dissection (SCAD)

• Chest discomfort or pressure
• Jaw, back or arm pain
• Shortness of breath
• Dizziness or light-headedness
• Extreme fatigue

Reasons why SCAD is often missed

• Non-classic symptoms: They can mirror signs like stress, indigestion, or general fatigue
• Standard test may appear normal: Routine ECGs or blood tests often, don’t pick it up
• Advanced imaging is required: Coronary angiography, sometimes with intravascular ultrasound (IVUS) or optical coherence tomography (OCT), is required for a clear diagnosis
• Most cases heal naturally: Unlike typical heart attack attacks, 90-95 percent of SCAD cases recover without stents, thus making correct diagnosis, essential
• Awareness is key: Women and doctors alike, need to consider SCAD, even when traditional risk  factors are  absent

FAQs on Symptoms of Heart Attack In Women

1. What are the common symptoms of a heart attack in women?

Chest discomfort or pressure, jaw, back, or arm pain, shortness of breath, dizziness or light-headedness, and extreme fatigue are common symptoms that may signal a heart attack in women.

2. Why is SCAD often missed in women?

SCAD is often missed because its symptoms can mimic stress, indigestion, or general fatigue. Routine ECGs or blood tests may appear normal, requiring advanced imaging for accurate diagnosis.

3. How does SCAD differ from traditional heart attacks?

SCAD is caused by a tear in the coronary artery wall, unlike traditional heart attacks caused by cholesterol build-up. It is linked to fragile arteries, hormonal changes, connective tissue disorders, inflammation, or intense stress.

4. Can younger women experience heart attacks?

Yes, younger women in their 30s, 40s, and early 50s can experience heart attacks, often due to SCAD, despite having few traditional risk factors.

5. How important is awareness of SCAD for women and healthcare professionals?

Awareness is crucial as timely diagnosis can prevent serious complications. Women and healthcare professionals need to consider SCAD even when traditional risk factors are absent.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.