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SCAD explained
What is spontaneous coronary artery dissection (SCAD)?
Spontaneous coronary artery dissection (SCAD) is a rare condition where there is a tear in the wall of a coronary artery. In some cases, this can lead to a heart attack or cardiac arrest.
Your coronary arteries supply blood to the heart and are made up of 3 layers. SCAD happens when 1 or more of the inner layers of a coronary artery tears away from the outer layer.
Blood can flow into the space between the layers, reducing or blocking the flow of blood through the artery.
This can lead to a heart attack or in very rare cases a cardiac arrest where your heart stops beating and blood is not being pumped blood around your body.
- Watch our video on the difference between a heart attack and a cardiac arrest
Signs and symptoms
What are the symptoms of SCAD?
Symptoms of SCAD may include feeling:
- chest pain
- tightness or pain in the arms, neck, jaw, upper back or stomach
- dizzy or lightheaded
- tired or out of breath
- sick or being sick (nausea and vomiting)
- sweaty or clammy.
They can feel similar to symptoms of angina (chest pain or discomfort) or a heart attack.
Call 999 if you have chest pain or any of the symptoms above.
People with SCAD often ignore symptoms especially if they appear fit and healthy and have no history of cardiovascular risk factors. But it’s important to get checked out if you get any SCAD symptoms, so it can be diagnosed as early as possible.
Causes
What causes SCAD?
We do not yet know what causes SCAD, or why it happens. It often happens out of the blue.
The condition cannot currently be predicted or prevented. Research is currently looking into what the risk factors for SCAD might be. But as the name "spontaneous" means, we cannot know when it is going to happen.
What we do know is that:
- SCAD most commonly occurs in women aged between 45 and 53.
- Many people with SCAD will have few or no risk factors for cardiovascular disease, such as high cholesterol, smoking or diabetes.
- People who have had SCAD will often have fibromuscular dysplasia, a rare condition affecting medium sized arteries, making them weak or stiff.
- At least 80% of people with SCAD are women.
- It can happen during, or soon after, pregnancy.
- SCAD may be triggered by extreme emotional stress.
Diagnosis
How is SCAD diagnosed?
SCAD is diagnosed post-event. This means you’ll find out you have SCAD after it has happened and you go to the hospital to be seen by a doctor.
SCAD is usually diagnosed through:
Treatment
How is SCAD treated?
Treatment for SCAD will vary from person to person depending on their condition and how severe their symptoms are.
Conservative treatment is recommended when the condition is stable. This means the doctor does not need to cut or break through the skin to access the inside of your body (no invasive treatment). You’ll usually be given medicines to manage your condition.
Most people will have a coronary angiogram, and following this, SCAD may be treated in the following ways:
- Medicines to prevent blood clots, such as aspirin.
- Medicines to lower blood pressure, such as beta blockers.
- Stents to open the blocked artery and help blood flow to your heart muscle.
- Coronary artery bypass surgery to help blood flow to your heart muscle. This treatment is rare for SCAD.
Recovery
Will I have cardiac rehabilitation?
If you have been diagnosed with SCAD, cardiac rehabilitation can help you get back to normal.
Cardiac rehab is a structured programme that involves exercising in a safe space, education on heart health and emotional support. It aims to help you recover and get back to living your life as fully as possible.
Speak to your GP if you have not been offered cardiac rehab.
If you cannot get to cardiac rehab for any reason, we offer a free online programme for you to do at home.
Visit our cardiac rehab hub to sign up for our free programme or watch the videos in your own time.
You can find out where your nearest cardiac rehabilitation programme is by visiting cardiac-rehabilitation.net
Get support
A SCAD diagnosis can be frightening, especially if you’ve found out about it after an emergency. Many SCAD patients experience feelings of isolation due to the rarity of the condition.
Many people tell us they feel anxious, panicky or depressed after diagnosis. This is completely understandable. It’s important to talk about these feelings, either to a trusted loved one, your GP, a cardiac rehab nurse, a clinical psychologist or counsellor.
There's also a growing community of people with SCAD in the UK and around the world. They support each other via a variety of social networking websites, including:
- Beat SCAD
- Rare Connect online SCAD community
- SCAD family and friends support group (Facebook group)
- SCAD UK & Ireland survivors group (Facebook group)
With us, you can:
- Speak to our cardiac nurses by phone, callback, email or online chat on Heart Helpline (Monday to Friday, 9am to 5pm).
- Sign up to our Heart Matters magazine for online tips, support and recipes to look after your heart health.
- Join our online HealthUnlocked community to speak to other people going through the same experience.
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