Pregnancy-Associated SCAD

Pregnancy-associated SCAD heart attacks account for less than 5-17% of SCAD cases and 1.81 per 100,000 pregnancies. SCAD can occur at anytime during or after pregnancy, however more than 70% of cases occur post-partum with the majority within the first week. Patients who develop SCAD during pregnancy tend to be much sicker with larger sized heart attacks or more than one coronary artery affected with SCAD.

It is recommended that all patients who have had SCAD should avoid pregnancy due to the high risk of recurrent SCAD heart attacks. Approximately 20% of patients have recurrent SCAD heart attacks with pregnancy. Patients with SCAD should consider permanent solutions to avoid future pregnancies or consider taking contraception. It is recommended that SCAD patients avoid estrogen containing contraception options and instead used long acting progesterone only methods including the subdermal levonorgestrel implant and the levonorgestrel-releasing IUD.