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Doctor's Desk


What is SCAD?

Spontaneous coronary artery dissection — sometimes referred to as SCAD — is an uncommon emergency condition that occurs when a tear forms in one of the blood vessels in the heart. Spontaneous coronary artery dissection (SCAD) can slow or block blood flow to the heart, causing a heart attack, abnormalities in heart rhythm or sudden death. Spontaneous coronary artery dissection (SCAD) most commonly affects women in their 40s and 50s, though it can occur at any age or in men. People who develop spontaneous coronary artery dissection (SCAD) are often healthy. Most don't have risk factors for heart disease, such as high blood pressure and diabetes.Spontaneous coronary artery dissection (SCAD) can lead to sudden death if it isn't diagnosed and treated promptly. For this reason, seek emergency attention if you experience heart attack signs and symptoms — even if you think you aren't at risk for a heart attack.

Signs and Symptoms of SCAD:

Signs and symptoms of spontaneous coronary artery dissection (SCAD) are the same as symptoms of other types of heart attacks and may include:

  • Chest pain

  • A rapid heartbeat or fluttery feeling in your chest

  • Pain in your arms, shoulders or jaw

  • Shortness of breath

  • Sweating

  • Unusual, extreme tiredness

  • Nausea

  • Dizziness

Spontaneous coronary artery dissection (SCAD) causes a tear inside an artery. When the inner layers of the artery separate from the outer layers, blood can pool in the area between the layers. The pressure of the pooling blood can make a short tear much longer. And blood trapped between the layers can form a blood clot (hematoma).

Spontaneous coronary artery dissection (SCAD) may slow blood flow through the artery to the heart, which makes the heart muscle weaken. Or blood flow through the artery can be completely stopped, causing heart muscle to die (heart attack). A heart attack that occurs in SCAD is different from a heart attack caused by hardening of the arteries (atherosclerosis).

Risk Factors for SCAD:

Doctors and researchers have found some similarities among people who have experienced spontaneous coronary artery dissection (SCAD). It's not yet clear what role these factors play in causing the disease. Common factors include:

  • Female sex. Though spontaneous coronary artery dissection (SCAD) can occur in both men and women, it tends to affect women more often.

  • Giving birth. Some women with spontaneous coronary artery dissection (SCAD) have recently given birth. Spontaneous coronary artery dissection (SCAD) was found to occur most often in the first few weeks after delivery.

  • Underlying blood vessel conditions. Some underlying blood vessel abnormalities have been associated with SCAD, most commonly a condition called fibromuscular dysplasia (FMD), which causes the irregular growth of cells in the walls of one or more of your arteries. This irregular growth can weaken the artery walls, leading to blockages, dissections or aneurysms. Fibromuscular dysplasia can also cause high blood pressure, a stroke and tears in other blood vessels. Fibromuscular dysplasia occurs more often in women than it does in men.

  • Extreme physical exercise. People who recently participated in extreme or intense exercises, such as extreme aerobic activities, may be at higher risk of SCAD.

  • Severe emotional stress. Someone who has experienced severe emotional stress, such as a sudden death in the family, may be at higher risk of SCAD.

  • Blood vessel problems. Diseases that cause inflammation of the blood vessels, such as lupus and polyarteritis nodosa, have been associated with spontaneous coronary artery dissection (SCAD).

  • Inherited connective tissue diseases. Genetic diseases that cause problems with the body's connective tissues, such as vascular Ehlers-Danlos syndrome and Marfan syndrome, have been found to occur in people with spontaneous coronary artery dissection (SCAD).

  • Very high blood pressure. Having untreated, severe high blood pressure can be associated with spontaneous coronary artery dissection (SCAD).

  • Illegal drug use. Using cocaine or other illegal drugs may increase the risk of spontaneous coronary artery dissection (SCAD).

  • In some people, spontaneous coronary artery dissection (SCAD) can occur again, despite successful treatment. It may recur soon after the initial spontaneous coronary artery dissection (SCAD) or years later. People who have spontaneous coronary artery dissection (SCAD) may also have a higher risk of other heart problems, such as heart failure.


1. Accessed online at the Mayo Clinic.

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