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Spontaneous coronary artery dissection: a systematic review of physical and psychosocial recovery following discharge from hospital

Neubeck, Lis; McHale, Sheona; Ross, Mark; MacGillvray, Steve; Galbraith, Mary; Hanson, Coral


Mark Ross

Steve MacGillvray

Mary Galbraith


Spontaneous coronary artery dissection (SCAD) is increasingly recognised as an important cause of myocardial infarction, particularly among women. SCAD survivors may not know what physical activity is safe and effective and there may be a psychosocial burden of living with a SCAD diagnosis. This review aimed to determine the evidence regarding physical activity, cardiovascular risk factors, or associated factors, and the psychosocial impact of SCAD for SCAD survivors after hospital discharge.
A systematic review completed in accordance with PRISMA guidelines (Prospero CRD42021254798).
The review included 28 studies. These used a range of methods. None were randomised controlled trials. There were 4167 SCAD participants although some were sourced from the same SCAD registries, so may not be unique. They were mainly female (n=3897 93.5%, range=57.7%-100%), with mean age 48.0±9.8 years at index event. Participants mostly came from the USA, Canada, or the Netherlands. We found very limited evidence for cardiorespiratory fitness improvements following cardiac rehabilitation (CR). Existing CR was not tailored to SCAD specific needs and SCAD survivors lacked guidance about appropriate physical activity. Some participants had high levels of psychosocial distress. SCAD survivors highlighted the need for tailored support that included family members. Many SCAD survivors have traditional risk factors including hypertension, hyperlipidaemia and overweight/obesity. Chest pain following SCAD is common.
There is an urgent need to develop physical and psychological recovery programmes for SCAD survivors, and test effectiveness via randomised controlled trials. Psychosocial support is particularly required, given the high burden of psychosocial issues.

Journal Article Type Review
Acceptance Date Mar 10, 2022
Online Publication Date Mar 15, 2022
Publication Date 2022-09
Deposit Date Jan 26, 2022
Publicly Available Date Mar 16, 2023
Journal European Journal of Cardiovascular Nursing
Print ISSN 1474-5151
Electronic ISSN 1873-1953
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 21
Issue 7
Pages 665-676
Keywords Spontaneous coronary artery dissection, cardiac rehabilitation, recovery, risk factors, physical activity, psychosocial health
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