From the Research
Association between SCAD and Migraine Headaches
- There is evidence to suggest an association between Spontaneous Coronary Artery Dissection (SCAD) and migraine headaches 1, 2, 3, 4, 5.
- Studies have reported a higher prevalence of migraine headaches in patients with SCAD, with lifetime and 1-year prevalence rates of 40% and 26%, respectively 1.
- Patients with SCAD and migraine headaches are more likely to be female, have SCAD at a younger age, and have a history of depression and post-SCAD chest pain 1, 2.
- Migraine-related disability has been quantified using the Migraine Disability Assessment (MIDAS) scale, with a mean score of 9.9 indicating mild to moderate disability 2.
- The presence of underlying carotid fibromuscular dysplasia has been associated with migraine headaches in patients with SCAD 2, 3, 4.
Clinical Characteristics of SCAD Patients with Migraine Headaches
- SCAD patients with migraine headaches are more likely to have aneurysms, pseudoaneurysms, or dissections, and to report recurrent post-SCAD chest pain 1.
- There is no significant difference in recurrent SCAD at 5 years for patients with versus without migraine headaches 1.
- Patients with SCAD and migraine headaches have higher rates of depression and anxiety compared to those without migraine headaches 2.
- The use of triptans and daily migraine prophylactic medications is common among patients with SCAD and migraine headaches 2.
Pathophysiological Risk Factors for SCAD
- Fibromuscular dysplasia, other arteriopathies, pregnancy and female sex hormone changes, migraines, inflammatory conditions, and stress are potential pathophysiological risk factors for SCAD 4, 5.
- The exact pathophysiology of SCAD is unknown, and further investigation is needed to understand the relationship between these risk factors and the development of SCAD 5.