{
  "abstract": "Background The SCAD (Spontaneous Coronary Artery Dissection) Clinic in Scotland was developed in response to a growing body of Scottish-led research and direct requests from people with lived experience of SCAD.Aims The aim was to establish a specialist, patient-centred service to improve diagnostic accuracy, optimise treatment, and provide holistic support for people affected by SCAD in Scotland. Objectives included evaluating patient demographics, diagnostic changes, medication use, and patient support outcomes in the clinic’s first 18 months.Methods We reviewed routinely collected clinical data from 62 patients referred to the SCAD Clinic between its inception and February 2025. Data included patient demographics, diagnostic categorisation, imaging use, medication changes, hormonal health assessments, and cardiac rehabilitation referrals. Feedback from patients and referring clinicians was collected using the CARE patient experience tool and a bespoke clinician feedback form. Cost comparisons were made between the Scottish SCAD service and equivalent services in England.Results Of 62 patients, 73% (45/62) received a confirmed diagnosis of SCAD, while 27% had their initial diagnosis revised. Medication reviews led to more personalised prescribing, with statin use reduced from 68% to 40% and beta blocker use increased from 73% to 81%. Hormonal health support was offered to 23 patients. A total of 49 patients (79%) were referred to cardiac rehabilitation, and work is currently underway to develop an online SCAD-specific rehabilitation programme to enhance accessibility and engagement. All respondents to the CARE questionnaire rated the clinic as very good or excellent. A cost analysis indicated that providing care locally could save over £22,000 annually for 50 patients, compared to referral to services in England.Conclusions The Forth Valley SCAD Clinic, designed in partnership with patients, has demonstrated improvements in diagnostic accuracy, treatment personalisation, and recovery support. The model offers a cost-effective, scalable approach for delivering equitable specialist care across Scotland.",
  "authors": [
    {
      "affiliations": [
        "Edinburgh Napier University",
        "Wroclaw Medical University Hospital"
      ],
      "name": "Lis Neubeck"
    },
    {
      "affiliations": [
        "Edinburgh Napier University"
      ],
      "name": "Alice Pearsons"
    },
    {
      "affiliations": [
        "University of Leicester"
      ],
      "name": "Dave Adlam"
    },
    {
      "affiliations": [
        "NHS Forth Valley"
      ],
      "name": "Anne Scott"
    },
    {
      "affiliations": [
        "NHS Forth Valley"
      ],
      "name": "Clare Murphy"
    },
    {
      "affiliations": [
        "Edinburgh Napier University",
        "University of Leicester"
      ],
      "name": "Coral Hanson"
    }
  ],
  "title": "P32 Development of an outpatient clinic for people with spontaneous coronary artery dissection",
  "uid": "fe3fb256-4574-5c70-9c67-12b991cb9b9a"
}