Heart attacks in young women: A hidden culprit is finally getting attention.
While we often associate heart attacks with older individuals, a lesser-known condition called spontaneous coronary artery dissection (SCAD) is a leading cause of heart attacks in younger women. New research presented at the EAPCI Summit 2026 in Munich sheds light on this under-recognized threat, offering both hope and a call for further investigation.
But here's where it gets controversial: unlike traditional heart attacks caused by clogged arteries (atherosclerosis), SCAD involves a tear in the inner layer of a coronary artery. This tear allows blood to pool, forming a clot that restricts blood flow to the heart. Interestingly, most SCAD patients are healthy women with few typical risk factors for heart disease.
And this is the part most people miss: a Serbian study presented at the summit suggests that the common practice of inserting stents to open blocked arteries might not be beneficial for many SCAD patients. This finding challenges current treatment approaches and highlights the need for more research tailored to this specific condition.
The study, led by Prof. Svetlana Apostolović, analyzed data from 123 SCAD patients in Serbia. It found that the majority were women (85.4%) with an average age of 47.5. Interestingly, mental stress was identified as a potential trigger in 38.5% of cases, while physical stress played a role in 10.7%.
While stent implantation was performed in 28.5% of patients, the study revealed that it wasn't associated with better outcomes. In fact, stent implantation was an independent predictor of major adverse cardiovascular events (MACE) within 30 days of hospitalization.
This raises a crucial question: Should we be rethinking our treatment strategies for SCAD? Prof. Apostolović suggests a more conservative approach, emphasizing careful observation, beta-blockers, blood pressure medication, cardiac rehabilitation, and psychological support.
The ESC's ongoing multinational SCAD registry promises to provide even more insights into this complex condition. By understanding SCAD better, we can develop targeted treatments and potentially save lives.
What do you think? Should we prioritize research into alternative treatments for SCAD, or continue with current stent-based approaches? Share your thoughts in the comments below.
