Spontaneous Coronary Artery Dissection (SCAD)

What is Spontaneous Coronary Artery Dissection?

Spontaneous coronary artery dissection is a rare heart condition that affects more women than men. It is considered a life-threatening emergency that requires emergency treatment. The condition involves a rupture in any of the main blood vessels of the heart, resulting in massive bleeding and interruption of the heart’s normal function. It is often mistaken for a common heart attack, but it is more dangerous and requires different treatment.

What are the Symptoms of Spontaneous Coronary Artery Dissection?

Since the tear in the blood vessel usually happens quickly and without warning, you can’t rely on symptoms as early indicators of risk. It is also not associated with heart disease or the risk factors for it. Symptoms of a sudden rupture include:

  • Sweating
  • Chest and arm pain
  • Dizziness
  • Nausea

These symptoms are the same as those of any other heart attack. When a heart attack happens without secondary risk factors like clogged arteries or diabetes, it’s usually a case of spontaneous coronary artery dissection. Risk factors include hormonal changes such as pregnancy, extreme exercise routines, or genetic predisposition.

Spontaneous Coronary Artery Dissection (SCAD) Causes

While the exact cause of SCAD is unknown, there are many diseases associated with the condition which could be triggers. Individuals with a history of these diseases are at an increased risk of SCAD, but in many cases SCAD occurs without the patient having an underlying condition or known risk factors. 80% of people with SCAD are female, which suggests that something within the female physiology increases the risk of the condition.

Firstly, SCAD can occur during or just after pregnancy, and it also often occurs just before or during a menstrual period. This suggests that there could be a hormonal trigger for the condition.

Fibromuscular dysplasia (FMD) is another disease linked strongly with SCAD. With FMD, abnormal cells grow in the arteries which causes a narrowing or tearing of the artery walls.

Other possible causes or risk factors of SCAD include:

– Extreme physical exertion
– Severe emotional stress
– Connective-tissue abnormalities and genetic mutations, such as vascular Ehlers-Danlos syndrome, Marfan syndrome, polycystic kidney disease, Loeys-Dietz syndrome and pseudoxanthoma elasticum

How is Spontaneous Coronary Artery Dissection Treated?

Emergency stent surgery is the most common treatment for life-threatening cases. This stops the bleeding and allows the heart to stabilize function. A full bypass can also help when there is already muscle and blood vessel damage. If the condition is not threatening the heart immediately, it is usually managed with blood pressure control medication and lifestyle changes alone. Only a cardiologist can determine which cases of spontaneous coronary artery dissection require surgery.

Spontaneous Coronary Artery Dissection (SCAD) Prevention

Since many instances of SCAD occur without any underlying health conditions or known risk factors, there is no scientific evidence which helps us to prevent SCAD. However, maintaining a healthy heart and cardiovascular system is recommended.

Smoking is a major contributor to heart disease, so it’s an important habit to quit. High blood pressure and high cholesterol can also lead to heart disease, so it’s important to have these checked out regularly and take steps to reduce them if they are high.

In general, the best way to lower high blood pressure and cholesterol is to adopt a healthy diet, be more active and maintain a healthy BMI. 30 minutes of moderate activity, three times each week, is the recommended amount of exercise to help maintain a healthy heart. A balanced diet, rich in fruits, vegetables, whole grains and legumes is recommended, while fat and sugar consumption should be moderated.

Last Reviewed:
October 10, 2016
Last Updated:
November 21, 2017