Spontaneous Coronary Artery Dissection (SCAD)

Spontaneous Coronary Artery Dissection (SCAD) is when a tear suddenly happens in a heart artery wall. This tear allows blood to accumulate within the inner and outer layers of the artery wall, blocking blood flow to the heart muscle and causing issues like heart attack, rhythm problems, and in some cases, cardiac arrest.

Who is at risk?

• Women, most commonly between ages 40-50
• People with few cardiac risk factors (high blood pressure, diabetes, high cholesterol)
• People with connective tissue disorders and inflammatory conditions
• People experiencing severe emotional or physical stress
• Pregnant women or post-delivery

• Chest pain
• Pain in the arms, shoulders, jaw, neck, back, or stomach
• Excessive sweating
• Unusual fatigue
• Nausea or vomiting
• Dizziness

An electrocardiogram (ECG) is conducted. If heart injury is suspected, blood tests, including troponin levels (a marker of heart injury) will be taken. Imaging of the heart arteries will be done via a coronary angiogram procedure to provide details on the tear location and guide treatment.

Treatment is typically conservative to avoid high risks aggressive treatments. Emphasis is on letting the artery heal naturally by controlling blood pressure, taking medications like aspirin and beta-blockers, and cardiac rehabilitation. Occasionally, a stent may be inserted if SCAD blocks blood flow. In rare cases, coronary artery bypass surgery in needed to restore blood flow.