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What is spontaneous coronary artery dissection?

The artery wall is made up of thin layers of tissue. In spontaneous (carotid or coronary) artery dissection (SCAD), the layers separate and blood seeps in between the layers. The blood is trapped between the layers, causing a bulge in the wall that blocks the artery. This blocks or partially blocks blood flow to the heart and can cause a heart attack (if it is a total blockage) or chest pain (if it is a partial blockage).

SCAD is a rare condition, and doctors and scientists continue to expand their knowledge about it through research.

Who develops SCAD?

SCAD can occur at any age, but most cases occur in otherwise healthy people between the ages of 30 and 50. SCAD is far more common in women than men. In one study of 440 cases of SCAD that occurred at a single hospital between 1931 and 2008, 98 percent involved women.

What are the risk factors for having SCAD?

Doctors do not know exactly what causes SCAD or if it can be prevented. Although there is still a lot to be learned about SCAD, the following factors appear to increase the risk:

  • Female gender.
  • Pregnancy or giving birth, suggesting SCAD is linked to changes in hormones or blood volume that occur during pregnancy. One-third of all cases of SCAD occur during pregnancy or soon after giving birth.
  • Fibromuscular dysplasia (FMD), a disease that causes abnormal cell development in the artery wall.
  • Extreme exercise.
  • Underlying blood vessel inflammatory disease like lupus.
  • Connective tissue disease like Marfan syndrome.
  • Very high blood pressure.
  • Cocaine use.

What research is being done on SCAD?

Doctors have much to learn about treatment and prevention of SCAD. The National Institutes of Health is sponsoring studies at several major medical centers to try to determine what causes it. Mayo Clinic is heading up a database/registry of patients with SCAD (whether or not they have been patients at Mayo Clinic). By collecting data on patients with SCAD, researchers can identify patterns of SCAD incidence, causes and associations that could guide future research.

Reviewed: 12/15