Spontaneous coronary artery dissection (SCAD) occurs without warning and can lead to serious complications, including death. Symptoms can include chest pain, shoulder pain, shortness of breath, and more.
In the past, people believed SCAD was rare. Research now suggests that the issue may be
Those who develop SCAD do not typically have any risk factors for cardiac disease. They are also often younger than 50 years old and female. With treatment, most people can survive SCAD.
This article reviews what SCAD is, its symptoms, risk factors, treatment, and more.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
SCAD occurs when the innermost layer of the coronary artery (the artery that supplies blood to the heart) suddenly tears without warning, allowing blood to pass into the inner chamber.
The trapped blood then bulges inward, causing a blockage. It may also extend the tear, which can lead to a heart attack due to loss of blood.
In the past, experts
Signs and symptoms of SCAD resemble those that people associate with heart attacks. However, unlike a heart attack, about
Biological females have a higher chance of experiencing SCAD, as about
The tear allows blood to flow into a cavity, which creates an abnormal bulge. The bulge in the artery can block blood flow to the heart. Without treatment, this can lead to a heart attack.
The presentation of SCAD symptoms is similar to those of a heart attack. They
- chest pain or pressure
- shoulder pain
- shortness of breath or trouble breathing
- increased sweating
- temporary loss of consciousness
When tested, a person will also likely present with increased levels of cardiac enzymes, which indicate damage to the heart muscle (though these are not specific to SCAD).
As with any type of heart attack, recognizing signs quickly and seeking medical attention helps increase survival. An individual experiencing signs of a SCAD heart attack should seek immediate medical attention or call 911.
Diagnosis presents a challenge to doctors because people often lack common risk factors of cardiac disease. If a doctor suspects a person may have SCAD, they may perform several diagnostic tests to check for the condition.
Testing for SCAD often includes:
- Coronary angiography: This is often the first tool used for diagnosis. It uses X-rays to look at the blood vessels in a person’s heart.
- Intracoronary imaging: This is often used when coronary angiography does not conclusively show SCAD.
Some other possible diagnostic tools a doctor may use include:
SCAD resembles a heart attack, but it requires a different treatment plan. Due to limited knowledge about the condition, there is
Instead, a doctor will need to assess the location of the tear as well as the person’s symptoms.
Doctors often prefer conservative therapies, such as medications, to more invasive methods, such as stent placement. However, they may recommend the following:
- Revascularization: Due to risks of complications, a doctor will likely only recommend this procedure if necessary.
- Device implantation: A doctor may recommend the implantation of a cardioverter defibrillator or a mechanical left ventricular assist device for more serious cases.
- Medications: Studies do not definitively support the use of any specific medications. However, a doctor may recommend statin therapy, beta-blockers, or long-term aspirin.
People may also require a heart transplantation.
According to a
Some other risk factors may include:
Without treatment, SCAD can lead to major complications. These
- blocked blood flow to the heart
- heart failure
- cardiac-related death
With prompt medical attention, a person will likely survive SCAD. However, they will often need continued monitoring due to the risk of relapse.
Females, particularly those who are postpartum, tend to have a worse outlook than others.
SCAD is a spontaneous, sudden break in the inner wall of the coronary artery.
When it occurs, it can cause a person to have a heart attack and can lead to death.
A person who has SCAD does not typically have the warning signs and risk factors associated with heart disease. They also tend to be younger than those who are typically most at risk of a heart attack. Females are more likely to develop SCAD than males.
With treatment, most people recover from SCAD, though they have a higher chance of developing it again than someone who has never had SCAD.