Pregnancy-Linked SCAD More Severe

Data presented at the American College of Cardiology 75th Annual Scientific Session linked pregnancy-associated SCAD to more severe presentation and higher in-hospital major adverse cardiovascular events.

By
Kerri Miller
March 30, 2026
2 min

Conexiant

Overview

Pregnancy-associated spontaneous coronary artery dissection (P-SCAD) presents with more severe clinical manifestations compared to nonpregnancy SCAD, including higher rates of ST-segment elevation myocardial infarction (STEMI) and in-hospital major adverse cardiovascular events. Most patients in both groups were managed conservatively, but P-SCAD patients exhibited poorer left ventricular function recovery.

Background

Spontaneous coronary artery dissection (SCAD) is a significant cause of acute myocardial infarction, particularly in women. The unique physiological changes during pregnancy can exacerbate cardiovascular risks, making understanding P-SCAD critical for improving maternal outcomes. This study highlights the need for heightened awareness and tailored management strategies for pregnant patients experiencing SCAD.

Data Highlights

Parameter	P-SCAD	Non-Pregnancy SCAD
STEMI Rate	18.6%	5.5%
In-Hospital Major Adverse Events	Higher	Lower
Left Ventricular Ejection Fraction < 50% at 1 Year	Greater Proportion	Less

Key Findings

P-SCAD patients had a higher incidence of STEMI (18.6% vs. 5.5%).
More severe clinical presentations were noted in P-SCAD, including multivessel and multisegment disease.
Higher rates of in-hospital major adverse cardiovascular events were observed in P-SCAD patients.
Left ventricular ejection fraction recovery was less favorable in P-SCAD patients at 1 year.
Fibromuscular dysplasia was less common in the P-SCAD group.

Clinical Implications

Healthcare providers should be vigilant in recognizing the signs of P-SCAD, as it poses a higher risk for severe outcomes compared to nonpregnancy SCAD. Conservative management remains the standard approach, but clinicians should closely monitor left ventricular function and consider individualized counseling regarding future pregnancies.

Conclusion

The findings underscore the need for increased awareness and research into the management of P-SCAD to improve maternal cardiovascular health outcomes. Further studies are essential to optimize treatment strategies and long-term recovery for affected patients.