What is Spontaneous Coronary Artery Dissection?

A few healthy habits can help lower your risk of SCAD.

Spontaneous coronary artery dissection (SCAD) is uncommon, but serious. Here’s what to know about this rare and potentially life-threatening heart condition.

What is SCAD?

“Spontaneous coronary artery dissection (SCAD) happens when the inner layer of a coronary artery suddenly separates or tears, slowing blood flow to the heart,” says Caroline deRichemond, CRNP, advanced practitioner in the cardiology department at Geisinger.

That change in blood flow can lead to something called acute coronary syndrome. During acute coronary syndrome, blood flow to the heart muscle is blocked or reduced. This condition is common in younger women.

“The prevalence of SCAD is less than 5% of all acute coronary syndrome. It accounts for a third of cases in women under the age of 50,” deRichemond notes.

SCAD can affect anyone. But it’s more common in women than in men. It most commonly affects people between ages 44 and 55.

Postpartum and post-menopausal people are most at risk.

While SCAD can affect anyone, it is rare.

What are the symptoms of SCAD?

SCAD symptoms may look like a heart attack. Symptoms include:

Chest pain or pressure
Shortness of breath
Extreme fatigue
Sweating
Nausea
Vomiting
Upset stomach
Rapid heartbeat
Fainting

“You may have chest pain or pressure, but not always. Instead, you might notice pain in your arms, shoulders, jaw or back,” deRichemond says.

What causes SCAD?

The cause of SCAD isn’t well understood. But a few factors can raise your risk.

Some possible causes of SCAD include:

Uncontrolled high blood pressure
Prolonged stress
Illicit drug use, particularly cocaine
Pregnancy and childbirth
Connective tissue conditions that weaken artery walls, like Ehlers-Danos syndrome or Marfan syndrome
Genetics
Preeclampsia
Heart disease

Treating SCAD

SCAD is typically diagnosed in emergency settings. “Treatment for SCAD depends on the severity of the condition and your individual needs,” says deRichemond. “The main goal of treatment is to restore blood flow to your heart.”

Treatment options may include:

Medications

Some people may only need medicine to treat their SCAD and control symptoms like chest pain. Medicines used to treat SCAD may include:

Aspirin
Blood pressure medication
Anti-clotting agents

Surgery

If SCAD is more severe, you may need surgery to repair the damaged artery and restore blood flow. This could include bypass surgery or the placement of a stent to keep the affected artery open.

Sometimes, SCAD can go away on its own without treatment. Your healthcare provider will determine a treatment based on your individual needs.

After treatment, your provider may recommend a cardiac rehabilitation program to help you heal.

Prevention is everything

Your provider may recommend a few healthy habits to help you reduce your risk of developing SCAD. Or, if you’ve had SCAD, they’ll help you prevent it from happening again. Things you can do to help prevent SCAD may include: