Spontaneous Coronary Artery Dissection (SCAD) is often diagnosed in urgent situations, typically when someone is experiencing symptoms that mimic a heart attack. If you’re evaluated for SCAD, medical professionals will begin by gathering information about your health history, including any family history of heart conditions. To accurately diagnose SCAD and assess the condition of your heart, several diagnostic tests are crucial.
Diagnostic Tests for SCAD
The tests used to diagnose SCAD are similar to those employed when evaluating a heart attack. These tests aim to visualize the heart, assess its electrical activity, and detect any damage.
Cardiac Catheterization and Coronary Angiogram
The coronary angiogram is a pivotal procedure in diagnosing SCAD. It’s a type of cardiac catheterization. During cardiac catheterization, a thin, flexible tube called a catheter is inserted into a blood vessel, commonly in the wrist (radial artery) or groin (femoral artery). This catheter is then carefully guided to your heart.
In a coronary angiogram, once the catheter is positioned in the heart arteries, a contrast dye is injected through it. This dye makes the heart arteries visible on X-ray images. The angiogram allows doctors to see the coronary arteries clearly and identify any blockages or abnormalities, including the characteristic tears in the artery wall that define SCAD. This procedure is essential for visualizing the spontaneous coronary artery dissection and differentiating it from other heart conditions.
Electrocardiogram (ECG or EKG)
An electrocardiogram (ECG or EKG) is a rapid and painless test that records the electrical activity of your heart. Small adhesive electrodes are placed on your chest, arms, and legs to detect your heart’s rhythm and electrical signals. An ECG can indicate if you are experiencing or have experienced a heart attack. While it may not directly diagnose SCAD, it’s a crucial initial test to assess heart function and rule out other conditions, and to understand the immediate impact on the heart.
Blood Tests
Blood tests are a standard part of the diagnostic process for suspected heart issues. When heart muscle is damaged, as in a heart attack or SCAD, certain proteins are released into the bloodstream. Blood tests can detect these cardiac proteins. Elevated levels of these proteins can indicate heart damage. While not specific to SCAD, blood tests help confirm if heart muscle injury has occurred.
Optical Coherence Tomography (OCT)
Optical coherence tomography (OCT) is an advanced imaging technique that may be used during a coronary angiogram to get a more detailed view of the inside of the coronary arteries. OCT uses light to create high-resolution images of the blood vessel walls. A special catheter with a light source is guided to the heart arteries. OCT can help confirm the diagnosis of SCAD by visualizing the layers of the artery wall and identifying the dissection or tear with greater precision than a standard angiogram alone.
Intravascular Ultrasound (IVUS)
Intravascular ultrasound (IVUS) is another imaging technique that can be used during cardiac catheterization. IVUS uses sound waves to create pictures of the inside of the coronary arteries. A catheter with a tiny ultrasound transducer at its tip is inserted into a blood vessel and guided to the heart. The ultrasound waves create detailed images of the artery walls and surrounding structures. IVUS can help evaluate the extent and characteristics of the SCAD, providing additional information to guide treatment decisions.
SCAD Treatment Considerations
While the focus here is on diagnosis, it’s important to briefly understand that SCAD treatment aims to restore blood flow to the heart, manage chest pain, and prevent recurrence. Treatment strategies range from medications to procedures like angioplasty and stenting, or even bypass surgery in some cases. However, in certain situations, SCAD can heal naturally on its own.
Understanding Tortuous Arteries in SCAD Diagnosis
It’s worth noting that some individuals have naturally twisted or curved heart arteries, known as tortuous coronary arteries. While not directly related to causing SCAD, the presence of tortuous arteries can sometimes make Scad Diagnosis and treatment planning more complex. Coronary angiography can also identify tortuous arteries if present.
Key Takeaways for SCAD Diagnosis
Diagnosing SCAD typically involves a combination of tests performed in an emergency setting. Coronary angiography is the cornerstone of SCAD diagnosis, allowing doctors to directly visualize the coronary arteries and identify dissections. Other tests like ECG, blood tests, OCT, and IVUS provide complementary information to confirm the diagnosis, assess heart damage, and guide appropriate management strategies. If you experience chest pain or symptoms suggestive of a heart problem, seeking immediate medical attention is crucial for prompt diagnosis and care.
