Spontaneous coronary artery dissection (SCAD)

Spontaneous coronary artery dissection (SCAD) is when a tear appears in the wall of a coronary artery, which supplies blood to your heart. In some cases this can lead to a heart attack. 

Your coronary arteries are made up of three layers. SCAD happens when one or more of the inner layers of a coronary artery tears away from the outer layer.

Blood is able to flow into the space between the layers and a blood clot forms, reducing the flow of blood through the artery. 

This can lead to a heart attack, as the blood supply to your heart has been blocked. Or a cardiac arrest, when the heart stops pumping blood around your body. 

SCAD is a rare heart condition that occurs suddenly with no apparent warning. It is most common in women under the age of 50. The condition can’t currently be predicted or prevented. 

Those with SCAD are generally healthy. They often don’t smoke or have diabetes and aren’t usually overweight or obese. These are often the risk factors which can increase your chance of having a heart attack. This means that SCAD is often misdiagnosed or there is a delay in diagnosis.

What are the symptoms of spontaneous coronary artery dissection (SCAD)?

The symptoms are very similar to those of angina (chest pain or discomfort) or a heart attack. 

You may feel a heaviness or tightness in your chest. This may spread to your arms, neck, jaw, back or stomach. You may also feel short of breath, sick, sweaty and light headed. 

If the artery becomes completely blocked you may have a heart attack. If you have chest pain or any of the symptoms above, call 999 immediately.

What causes SCAD?

Unfortunately we do not yet know a great deal about SCAD, or why it happens. It often strikes out of the blue, but unlike many cases of coronary heart disease (CHD), the condition doesn’t appear to be preventable. 

Further research is needed to help us better understand this rare condition. 

What we do know is that:

  • SCAD most commonly occurs between adolescence and late 60s
  • many people with SCAD will have few or no traditional risk factors for heart and circulatory disease
  • at least 80% of those with SCAD are women
  • it can often occur during, or soon after, pregnancy. 

How is SCAD diagnosed?

SCAD is diagnosed post event. For example after having a heart attack. Research is currently looking into what the risk factors might be. But as the name ‘spontaneous’ suggests, it is not something we can predict at this stage. 

The symptoms are the same as for a heart attack, so the condition is usually diagnosed through having blood tests, an ECG and a coronary angiogram

How is SCAD treated?

Treatment for SCAD will vary from person to person depending on their condition and how severe their symptoms are.

Most people will have a coronary angiogram, and following this SCAD may be treated in the following ways:

  • with medication to prevent blood clots and reduce blood pressure if necessary
  • through inserting a stent in the affected artery 
  • having coronary artery bypass surgery to restore blood flow (although this is rare).

Cardiac rehabilitation

If you have a heart attack, you are usually referred to a cardiac rehabilitation service for specialist advice, support and physical activity. However, these are not available in all areas.

Cardiac rehab is a mix of exercising in a safe space, education, relaxation and psychological support. It aims to help you recover and get back to living your life as fully as possible. 

Heart attack booklet

Cover image heart attack booklet This booklet is for people who have had a heart attack, and their family and friends. It explains what a heart attack is and how it is treated, including primary coronary angioplasty.

It also has information about recovery from a heart attack. What you can do to help yourself stay healthy.

Order or download now

 

More info and support:

A SCAD diagnosis can be frightening. Many SCAD patients experience feelings of isolation due to the rarity of the condition. 

There is a growing community of SCAD patients in the UK and around the world. They support each other via a variety of social networking websites, including: