Department of Psychology and Neuroscience, University of Colorado Boulder (Drs Wagers and Stevens); Graduate School of Professional Psychology, University of Denver, Denver, Colorado (Dr Ross); SCAD Alliance, Alexandria, Virginia (Ms Leon); and Department of Psychology, University of Colorado Denver (Dr Masters). Dr Stevens is now affiliated with the Dartmouth Centers for Health and Aging and the Department of Psychiatry at the Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
J Cardiopulm Rehabil Prev. 2018 Nov;38(6):374-379. doi: 10.1097/HCR.0000000000000330.
Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic type of acute myocardial infarction that primarily affects young, healthy women without typical risk factors for heart disease. Few investigations have examined psychosocial variables in this population and none have looked at patient perceptions of the experience and stresses associated with having a SCAD event or the resources currently available to SCAD survivors. This investigation describes survivors' subjective experiences of SCAD. Participants also provided information about types and helpfulness of resources available to them post-SCAD, including cardiac rehabilitation.
Participants were recruited online and completed a one-time questionnaire.
Participants (n = 409) completed a questionnaire concerning their experiences with their SCAD event in the 1 y and 2 wk prior to the SCAD event. Their responses reflected moderate to high perceptions of stress. Participants experienced the SCAD event as highly stressful and frightening and their heart health presents as a moderate-severe source of current, post-diagnosis stress. Spontaneous coronary artery dissection-based informational support was frequently rated as inadequate, whereas other supportive resources varied in their helpfulness and accessibility. Participants reported positive experiences in cardiac rehabilitation and strong interest in SCAD-specific, professionally led, online patient education and support groups.
This study is the largest to date investigation of SCAD survivors and their experiences in this understudied and perhaps underrecognized condition. Opportunities for researchers and providers to develop, tailor, and disseminate SCAD-specific interventions are discussed.
自发性冠状动脉夹层（SCAD）是非动脉粥样硬化性急性心肌梗死的一种类型，主要影响无典型心脏病风险因素的年轻、健康女性。很少有研究调查该人群中的社会心理变量，也没有研究过患者对 SCAD 事件相关经历和压力的看法，以及 SCAD 幸存者目前可获得的资源。本研究描述了幸存者对 SCAD 的主观体验。参与者还提供了有关他们在 SCAD 后可获得的资源（包括心脏康复）的类型和有用性的信息。
参与者通过在线招募，并完成了一次性问卷调查。
参与者（n=409）完成了一份关于他们在 SCAD 事件前 1 年和 2 周内的经历的问卷。他们的回答反映了中等至高度的压力感知。参与者将 SCAD 事件视为高度压力和恐惧的事件，他们的心脏健康状况是目前诊断后中度至重度压力的来源。基于 SCAD 的信息支持资源经常被评为不足，而其他支持性资源在有用性和可及性方面存在差异。参与者报告了在心脏康复中的积极体验，并对 SCAD 特异性、专业主导的在线患者教育和支持小组表现出浓厚的兴趣。
这是迄今为止对 SCAD 幸存者及其在这一研究较少且可能认识不足的情况下的经历的最大研究。讨论了研究人员和提供者开发、定制和传播 SCAD 特异性干预措施的机会。
