November 2023

SCAD: The Under-the-Radar Heart Problem

Quick––what is SCAD?

If you didn’t guess “spontaneous coronary artery dissection” because you’ve never heard of that, don’t fret. Even though SCAD is increasingly recognized as a cause of heart attacks, the condition is not well-known. This lack of information about SCAD can leave people who experience the condition feeling shocked, confused, and scared. Knowing the basics can give you the information you need to speak with your healthcare provider about it.

What is SCAD?

SCAD is a spontaneous tear in the coronary artery wall.

The walls of the vessels that carry blood to your heart have three layers. SCAD occurs when one of those layers gets a tear in it. The tear allows blood to enter the artery wall, where it becomes trapped and creates a bulge. This bulge then blocks blood from reaching the heart, which can cause a heart attack.

What are its risk factors?

Researchers don’t know what causes SCAD. It can happen in people of any gender and nearly any age, and it often occurs in those who have few or no risk factors for heart disease.

But scientists have been able to point to a few common risk factors for SCAD. The majority of people affected by SCAD are women in their 40s and 50s. And even though SCAD in pregnant people is rare, the condition is the most common cause of heart attacks during pregnancy.

Researchers have also noted that many people who experience SCAD report feeling physical or emotional stress beforehand.

Other possible risk factors include having:

  • Fibromuscular dysplasia

  • Migraines

  • An inflammatory disorder

  • A connective tissue disorder

What are its symptoms?

Many heart attacks occur because of plaque buildup in coronary arteries––a common form of heart disease. But SCAD isn’t related to plaque at all, and people with SCAD don’t usually have heart disease risk factors.

In the absence of SCAD warning signs, it’s important to know the symptoms of a heart attack: chest pain, shortness of breath, dizziness, and sweating.

How is SCAD diagnosed and treated?

Providers may use tools that view the inside of arteries to diagnose SCAD. They can also use a special X-ray test called an angiogram, but SCAD may be more difficult to see with that method.

Treatment often focuses on controlling blood pressure and monitoring for recurrence.



Date Last Reviewed: 8/1/2023
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