LCHM Summer 2017 - 7

L C M E D S O C .O R G

Meagan Edelman Duarte's
SCAD story
 In 2016, at the age of 29, Meagan Edelman
Duarte of Northampton suffered a devastating
heart attack from SCAD only two months after
giving birth to her second son. Meagan was a
graduate of Northampton High School and
Moravian College, who worked as an agent of
ADP Insurance Company in Allentown. Unfortunately, despite prompt CPR and efforts by
her health care providers, Meagan's heart suffered
irreparable damage from the dissections and she
did not survive. She left behind her husband
Mark Duarte, her newborn son Kayden, her
17-month-old son Grayson and her loving and
devastated family and friends.

be performed, including serial ECGs and underlying extracoronary vascular abnormalcardiac biomarkers, such as troponin levels.            
ity, such as fibromuscular dysplasia (FMD).
Secondarily, pregnancy or post-partum status
Are there any differences in the rec- appears to have a relationship to the presence
ommended treatment for SCAD of SCAD. Finally, gene defects, such as Marfan
patients? Should SCAD patients be treated syndrome, Ehlers-Danlos syndrome type IV,
any differently than patients who have suffered and Loeys-Dietz syndrome, have all been related
a heart attack caused by atherosclerosis?
to SCAD.
Research has identified that treatment options
for SCAD patients differ significantly from those
There are also a number of triggers which
of a typical heart attack patient. The premise that appear to be connected to the occurrence
the patient should be treated with a balloon and of SCAD, including high intensity workouts,
stenting in less than 90 minutes, which has been extreme emotion or emotional events and extreme
proven very effective (over 90%) in patients with stressors; there are, however, patients who have
atherosclerosis, simply does not work as well for no triggers or underlying conditions at all, yet
SCAD patients (65-70% success rate).
they experience SCAD.

Q

Angiographic diagnosis of SCAD is critical
From the Expert
to the treatment decision, since the placement
What is spontaneous coronary artery of a stent can extend the dissection and cause
dissection or SCAD?
more heart damage in a SCAD patient, leading
Dr. Sharonne Hayes, Lead SCAD Investi- to further complications and the need for more
gator at Mayo Clinic: Spontaneous Coronary invasive treatment. In many instances, where the
Artery Dissection is an uncommon and under-rec- patient is stable and the artery is not occluded,
ognized cause of acute coronary artery syndrome the best treatment for SCAD is to leave it alone,
(heart attack) which results from obstruction of treating it conservatively with only medical
blood flow to the heart muscle due to a split management and close observation.  
between layers of the artery wall and/or bleeding
between the layers forming a type of "bruise" in
SCAD patients typically remain hospitalized
the artery which is called an intramural hematoma. longer (~3-5 days), to enable appropriate obserSCAD is completely different from a typical vation in the event of an early extension of the
heart attack, which results from the disruption dissected vessel. In the event of a blockage or
of plaque within the coronary vessels.
extended dissection, treatment options include
bypass or placement of a stent. Stents are typically
When should a care provider consider only utilized when necessary to preserve life or
the possibility that a patient is presenting to restore a totally occluded artery.
with a SCAD heart event? 
Healthcare providers, including emergency
Overall, there is a dramatic difference between
medicine specialists, internists, obstetricians recommended treatment of SCAD patients versus
and cardiologists, should consider the pos- that of regular heart attack patients. 50-90% of
sibility of SCAD when faced with a young dissected arteries in SCAD patients, when left
patient with cardiac symptoms. It is critically alone and managed conservatively, go on to heal
important to recognize the existence of a heart on their own.
attack in an otherwise young and healthy
patient, where that diagnosis would not be
Are there underlying conditions that
high on the differential diagnosis. 90% of
appear to be associated with SCAD
SCAD patients are young, healthy women that may increase a person's susceptibility
without risk factors for cardiac disease and to suffering a SCAD heart attack?
for that reason, prompt recognition of heart
There are a number of underlying conditions
attack symptoms is most critical. Once a that appear to be related to the presence of
heart attack is suspected, appropriate tests SCAD, although the actual connections remain
to confirm or rule out the diagnosis need to uncertain. The most common condition is an

Q

Q

Q

Q

What is the goal of your research team at
the Mayo Clinic with regard to SCAD?
 The ultimate goal of our research is to identify
the causes of SCAD as well as the means to predict
and prevent this devastating disease. While we
are a long way from definitive answers, we have
made great strides in recent years. We no longer
rely solely upon autopsy findings as a means of
conducting research on this disease, but rather
have identified trends in live patients that have
provided significant connections between underlying conditions and the presence of SCAD. Our
research has also identified the most effective
means of treating SCAD and has demonstrated
positive outcomes for SCAD patients.

Q

Where has most of the funding for SCAD
research come from?
SCAD Research, Inc. has been the most
significant source of SCAD research funding. In
addition, the Mayo Clinic has provided many
resources both in terms of finances, personnel
time and in-kind resources. The Mayo Clinic
SCAD Registry is the largest in the world and
it collaborates with other facilities in conducting
research on this uncommon, but not rare,
devastating disease.         
Local Opportunities for Funding
Research and for Support
  Are there any local events in the near
future that would permit local hospitals,
care providers, patients, and others to support
SCAD research?      

Q

Continued on page 8
SUMMER 2017 | Lehigh County Health & Medicine 7


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