Patients’ perceptions of physical activity and cardiac rehabilitation after spontaneous coronary artery dissection (SCAD): a focus group study in Sweden

Objectives Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome mainly affecting younger to middle-aged women. Physical activity has been discussed as a potential trigger for SCAD. This study aimed to explore the perceptions of physical activity among patients and their experiences of cardiac rehabilitation following the event. Design Qualitative descriptive study using digital focus groups and inductive qualitative content analysis. Setting Six digitally conducted focus groups (Zoom) in Sweden. Participants Twenty-six women and three men (median age 57 years) who had experienced SCAD within the past 3 months to 3 years were recruited via a national SCAD peer-support group and eight university hospitals. Results Participants continually re-negotiated their bodily capacity after SCAD, marked by fear, uncertainty and a loss of bodily trust. Difficulty interpreting bodily signals and fear of physical strain often led to avoidance of physical activity. Recovery was experienced as slow and unpredictable, reinforced by inconsistent or insufficient advice from healthcare professionals. Limited follow-up and lack of SCAD-specific rehabilitation contributed to feelings of isolation and abandonment. Despite these challenges, participants gradually developed personal strategies to rebuild strength and confidence. Peer interaction and shared experiences contributed to emotional safety, motivation and hope during rehabilitation. Conclusion Post-SCAD rehabilitation should address both physical and emotional recovery through coherent, person-centred follow-up with individualised guidance and opportunities for peer support to reduce uncertainty and support long-term recovery. Trial registration number Not applicable.