{"id":7224,"date":"2025-05-29T11:16:55","date_gmt":"2025-05-29T08:16:55","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=7224"},"modified":"2025-05-29T11:16:55","modified_gmt":"2025-05-29T08:16:55","slug":"%f0%9f%94%8d-spontaneous-coronary-artery-dissection-scad-in-extreme-athletes","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/%f0%9f%94%8d-spontaneous-coronary-artery-dissection-scad-in-extreme-athletes\/","title":{"rendered":"\ud83d\udd0d Spontaneous Coronary Artery Dissection (SCAD) in Extreme Athletes"},"content":{"rendered":"
\ud83d\udd0d Spontaneous Coronary Artery Dissection (SCAD) in Extreme Athletes<\/div>\n
Source:\u00a0 Medscape \u2013 May 23, 2025 | Commentary by Dr. Melissa Walton-Shirley<\/div>\n
<\/div>\n
\ud83e\udde0 Case Highlight: Nicholas Troutman (Extreme Kayaker)<\/div>\n
\u2022 36-year-old world champion kayaker developed SCAD after days of exertional chest pain.<\/span><\/div>\n
\u2022 Initially dismissed symptoms as caffeine or anxiety.<\/span><\/div>\n
\u2022 Eventually diagnosed with 100% LAD occlusion due to a 36mm coronary dissection.<\/span><\/div>\n
\u2022 Treated with aspirin, clopidogrel, and metoprolol; EF now 50%.<\/span><\/div>\n
\u2022 Despite medical advice to quit extreme sports, he returned to competition with nitroglycerin in hand.<\/span><\/div>\n
<\/div>\n
\ud83e\ude7a About SCAD (Spontaneous Coronary Artery Dissection)<\/div>\n
\u2022 Accounts for ~4% of acute coronary syndromes (ACS); ~40% of MIs in women under 50.<\/span><\/div>\n
\u2022 Often affects women after emotional trauma; men typically after extreme physical exertion.<\/span><\/div>\n
\u2022 SCAD Types (Yip-Saw classification):<\/span><\/div>\n
\u2022 Type 1: Contrast in false lumen \u2013 easier to recognize.<\/span><\/div>\n
\u2022 Type 2a\/2b: Long, smooth narrowing with or without distal involvement.<\/span><\/div>\n
\u2022 Type 3: Mimics atherosclerosis but lacks classic features.<\/span><\/div>\n
\u2022 Type 4: Total occlusion (as in Troutman\u2019s case).<\/span><\/div>\n
<\/div>\n
\ud83d\udc8a Management & Treatment<\/div>\n
\u2022 Medical therapy preferred unless unstable:<\/span><\/div>\n
\u2022 Aspirin lifelong, short-term dual antiplatelets, beta-blockers.<\/span><\/div>\n
\u2022 PCI\/CABG only in specific scenarios (left main SCAD, ischemia, instability).<\/span><\/div>\n
\u2022 Underlying conditions to assess: Fibromuscular dysplasia, connective tissue diseases, systemic inflammation, certain drugs (e.g., THC, cocaine).<\/span><\/div>\n
<\/div>\n
\ud83e\uddec SCAD Workup & Monitoring<\/div>\n
\u2022 Requires long, detailed evaluations.<\/span><\/div>\n
\u2022 Consider genetic testing for recurrent SCAD, male patients, family history, or multivessel involvement.<\/span><\/div>\n
\u2022 Fibromuscular dysplasia (FMD) is a key condition to screen for.<\/span><\/div>\n
<\/div>\n
\ud83c\udfc3\u200d\u2640 Lifestyle Recommendations After SCAD<\/div>\n
\u2022 Pregnancy: Generally discouraged unless managed by a cardio-obstetric team.<\/span><\/div>\n
\u2022 Exercise:<\/span><\/div>\n
\u2022 Light\/moderate aerobic and strength training with low resistance encouraged.<\/span><\/div>\n
\u2022 Avoid high-intensity, competitive sports, and activities involving strain or neck extremes.<\/span><\/div>\n
\u2022 Avoid triggers (Valsalva, roller coasters, chiropractic manipulations).<\/span><\/div>\n
<\/div>\n
\u26a0 Risk of Recurrence & Final Thoughts<\/div>\n
\u2022 Recurrence risk: 10\u201320%.<\/span><\/div>\n
\u2022 Troutman\u2019s decision to resume kayaking illustrates patient autonomy in balancing identity and risk.<\/span><\/div>\n
\u2022 Physicians must guide, inform, and support\u2014even if patients take high-stakes risks.<\/span><\/div>\n
https:\/\/click.mail.medscape.com\/?qs=4cc85903331ce9cc9021cf736e76c5197679eefa062db72e7dcf2fa3a09e0590cb4c402597dddd1f661f42566641779cc6155fe5933dc2c49832cfcfc745f48e<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"

\ud83d\udd0d Spontaneous Coronary Artery Dissection (SCAD) in Extreme Athletes Source:\u00a0 Medscape \u2013 May 23, 2025 | Commentary by Dr. Melissa Walton-Shirley \ud83e\udde0 Case Highlight: Nicholas Troutman (Extreme Kayaker) \u2022 36-year-old world champion kayaker developed SCAD after days of exertional chest pain. \u2022 Initially dismissed symptoms as caffeine or anxiety. \u2022 Eventually diagnosed with 100% LAD […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-7224","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7224","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=7224"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7224\/revisions"}],"predecessor-version":[{"id":7225,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7224\/revisions\/7225"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=7224"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=7224"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=7224"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}