The following is a summary of “Spontaneous Coronary Artery Dissection Across the Health Care Pathway: A National, Multicenter, Patient‐Informed Investigation,” published in the December 2023 issue of Cardiology by Bouchard et al.

Current clinical guidelines for managing spontaneous coronary artery dissection (SCAD) still need to be established, leaving uncertainties about targeted interventions and patient outcomes. To address these gaps, patient-informed data are crucial to substantiate observational research and establish evidence-based practices for managing and recovering individuals with SCAD. This study randomly selected 89 patients diagnosed with SCAD (86.5% women, mean age 53.2 years) from five major tertiary care hospitals. These patients completed sociodemographic and medical questionnaires and engaged in interviews guided by a patient-tested structured interview guide. 

The transcripts of these interviews underwent framework analysis involving inductive and deductive coding techniques, resulting in approximately 1,500 transcribed pages of interview data. Emotional distress, notably anxiety symptoms, was a commonly reported precipitating factor (56%) for SCAD. Interestingly, patient awareness and recognition of SCAD as a cardiac event were low (35%), while healthcare providers’ perception of SCAD detection was moderate (55%). Patients reported poor communication from healthcare providers regarding prognosis and self-management strategies (79%). 

Moreover, post-event psychological disorders were evident in 30% of patients, and a significant majority (73%) harbored fear of recurrence. Patients expressed a desire for tailored short- and long-term follow-up care (72%), emphasizing the need for secondary prevention programs despite low completion rates (48%) of conventional cardiac rehabilitation and the perception of inadequacy in current programming. This preliminary patient-oriented research highlights critical implications for SCAD patients’ acute and long-term management, suggesting the need for further validation and exploration of hypotheses generated through this study.

Source: ahajournals.org/doi/10.1161/JAHA.123.032141