Psychological Profile and Intervention Needs of Patients with Spontaneous Coronary Artery Dissection

Spontaneous coronary artery dissection (SCAD) is a serious medical condition that occurs when the lining of an artery in the heart separates or tears. This may cause a heart attack. The exact cause of SCAD is unknown but almost half of these patients report an emotional trigger. Patients with SCAD are at higher risk for experiencing future cardiac events and developing psychiatric illness post-event. Tailored psychosocial counselling for these patients in cardiac rehabilitation is sorely needed. As a first step to develop an intervention supporting patients as they cope with the challenges of SCAD, the overall aim of this research is to measure the psychological health and intervention needs of patients with SCAD. This research will include two studies. Study 1 will include interviews with 45-60 patients with SCAD asking about their psychological health and intervention needs. Study 2 will include a survey on these topics with a larger number of patients with SCAD (N=323). We will compare their psychological health to 323 patients that have had an acute coronary event due to atherosclerosis. Patients will be recruited from three sites within Canada: Vancouver General Hospital, the University of Ottawa Heart Institute, and QEII Health Sciences Centre (Halifax). To investigate the relationship between psychological health and cardiac outcomes, we will link our data with Canadian medical data measuring future cardiovascular events. Although clearly an important factor pre- and post-SCAD, the psychological health of patients with SCAD has been neglected to date. Preliminary work indicates that patients with SCAD are distressed. This distress deserves treatment. If this distress is associated with worse cardiac outcomes, there is an even greater reason to intervene. The information obtained in these studies will be used to design a targeted, patient-approved intervention with the potential to impact SCAD patients' mental health, quality of life, and heart health.