Dr. Leslie Cho, Director of Women’s Cardiovascular Center and Section Head, Preventive Cardiology

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 are the symptoms of SCAD?

For many people the first symptom of SCAD is a heart attack because the dissection has caused a complete blockage in the artery. Even if the coronary artery is not completely blocked, symptoms are the same as heart attack because the heart is not getting enough blood:

  • Chest pain
  • Rapid heart beat
  • Shortness of breath
  • Sweating
  • Unusual tiredness
  • Nausea
  • Dizziness

SCAD is an urgent situation. An individual experiencing chest pain alone or in combination with any of the other symptoms should or call 911.

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