Around 10% of SCAD patients are pregnant or post-partum and it’s estimated that 50% of heart attacks in patients who have recently given birth are due to SCAD.
Patients have told us that when they have cardiac symptoms they are often dismissed as pregnancy- or hormone-related, which leads to delayed diagnosis and sometimes devastating outcomes.
Beat SCAD has produced a series of videos discussing pregnancy-related SCAD (P-SCAD). They are aimed mainly at healthcare professionals, but patients will also find them useful.
In the Introduction to P-SCAD video Trustee Sarah Coombes explains what P-SCAD is and the symptoms to watch out for. She explains that patients are often told they are ‘too young’ or ‘too full of hormones’ to be having a heart attack and are checked for pulmonary embolism or pre-eclampsia, but rarely for cardiac conditions, even when they are displaying clear cardiac symptoms.
We talked to Dr David Adlam (UK SCAD Research Lead, Associate Professor of Acute and Interventional Cardiology at University of Leicester & Honorary Consultant Interventionalist Cardiologist at University Hospitals Leicester) about P-SCAD, when it can happen, how common it is, and the findings of a recent research paper on P-SCAD. He also discusses the risks of recurrence in post-SCAD pregnancies.
And three P-SCAD patients tell their very different stories and offer some advice to healthcare professionals presented with a pregnant or post-partum patient who is having cardiac symptoms.
Bronnach had to retire from the teaching job she loved aged 34 after having a SCAD following the birth of her third son. She is now living with heart failure. When she was feeling unwell during her pregnancy, she spoke to her midwife and says “I was made to feel like I was a nuisance.” She adds: “I do often wonder if someone had listened to me, listened to the fact that I just didn’t feel right, could my life have not been impacted as badly as it is now?”
Zoe had a SCAD and cardiac arrest while having dinner with friends. She’d given birth to her daughter a few weeks before and there was no warning that there might be a problem with her heart. “SCAD can happen to anyone and can present in many different ways,” Zoe tells us. She adds: “Don’t always assume that symptoms like pain in the arm or chest are automatically going to be down to breastfeeding or that tiredness is automatically down to having a baby… it could be something else.”
After having her baby, Geri felt unwell but, despite her husband, who is a firefighter, saying he thought she was having a heart attack, she didn’t believe that could be happening. “I never knew anybody like me who had a heart attack. That’s why I didn’t believe or trust in anything,” says Geri. She was referred to a SCAD specialist and says, “If it wasn’t for that, I wouldn’t have made the recovery that I have.”
SCAD patients tend not to fit the ‘profile’ of people who are at risk of heart attacks, so are more likely to be misdiagnosed when presenting with clear cardiac symptoms. Assumptions can be made that symptoms displayed by pregnant or post-partum patients are related to the pregnancy and P-SCAD patients often have worse outcomes than other SCAD patients. Time is muscle and a simple Troponin test can diagnose or rule out a cardiac condition.
Sarah Coombes says: “We hope these videos will raise healthcare professionals’ index of suspicion when presented with a pregnant or post-partum woman who ‘just doesn’t feel right’. Think SCAD and you may save a heart… or even a life!”
Click here for a quick overview of P-SCAD and these patient stories and have a look at the resources below for more information about P-SCAD.
Dr Adlam, Bronnach, Zoe and Geri offer some advice for healthcare professionals who are presented with a pregnant or post-partum lady displaying cardiac symptoms.
Click below to watch the patient stories:
Many thanks for their help in making this video to… Dr David Adlam, SCAD patients Bronnach, Zoe and Geri, as well as Sophie and her team at Triskelle Pictures.
The costs of making these films were covered by a grant we received to help us raise awareness of P-SCAD.
Beat SCAD Summary of the above paper. (Many thanks to volunteer Ria Griffiths for her help with this.)
Pregnancy-related SCAD patient stories