Spontaneous coronary artery dissection (SCAD) is a rare condition that occurs when there is bleeding or tearing of the innermost layer of the artery wall. SCAD causes chest pain (angina pectoris), heart attack (myocardial infarction), cardiac arrest, and possibly death.

SCAD most commonly affects young women during pregnancy or shortly after delivery. It is also known to occur in female and male athletes during intense exercise. SCAD sometimes occurs in other patients for no identifiable cause. Most patients with SCAD do not have the normal risk factors for coronary artery disease, like high blood pressure, high bad cholesterol, diabetes, and smoking.

With SCAD, the tear or bleeding in the vessel wall blocks blood from continuing through the coronary artery to the to the heart muscle. This blockage, if not treated quickly, causes permanent damage to heart muscle tissue.

Below you can see a healthy coronary artery with normal blood flow.


In the next picture you can see a coronary artery with dissection. As more blood flows into the torn layer, a blockage can form.


Symptoms of SCAD

The symptoms of SCAD are the same as those felt during a heart attack, including the following:

  • Uncomfortable pressure, fullness, or squeezing pain in the center of the chest
  • Lasts more than a few minutes
  • Can spread to the shoulders, neck, or arms
  • Can be accompanied by light headedness, fainting, sweating, nausea, vomiting, or shortness of breath

Risk Factors for SCAD

  • Gender: Women may be more prone to SCAD, particularly during pregnancy or soon after delivery
  • Intense physical exercise
  • Intense emotional stress
  • Inherited/genetic conditions: A number of genetic diseases have been considered as risk factors for SCAD, including Marfan’s syndrome, Ehlers Danlos syndrome, and other related connective tissue diseases
  • High blood pressure
  • Drug use: Cocaine, methamphetamines and other illicit drugs may cause SCAD. Similarly, a number of stimulant supplements that may be available over-the-counter may also cause SCAD

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