What is Spontaneous Coronary Artery Dissection (SCAD)?
Spontaneous Coronary Artery Dissection (also known as SCAD), is a heart disease which is becoming more common than previously thought. When you have an incidence of SCAD, the coronary arteries which supply blood to your heart can develop a tear in their inner layer.
When the tear in your artery occurs, blood can seep into the different layers of your arteries, resulting in a potential blockage, which can slow down and block the flow of blood to your heart.
This tear can be problematic as it may result in heart conditions including rhythm issues, chest pain/angina, heart attack as well as death.
Women unfortunately are at most risk of SCAD, with sufferers typically aged in their 40s-50s, however women as well as men of any age can suffer from SCAD. Furthermore, those affected by SCAD typically do not have standard risk factors for Heart Diseases.
SCAD as a condition is still often misdiagnosed and treated as an instance of Heart Attack, however understanding and management of SCAD has rapidly improved in recent years.
Causes of SCAD
The causes of SCAD are still not as clearly known as other Heart Diseases; however, there are some conditions or factors which have been linked to incidence of SCAD.
These factors include:
- Conditions affecting blood vessels, including a condition called Fibromuscular Dysplasia
- Female sex
- Pregnancy and birth
- Use of recreational drugs
- Major emotional stress
- Major exercise
- Inflammatory medical conditions such as Rheumatoid Arthritis and Lupus
- Hormonal therapies
- Disorders affecting connective tissue including Marfan Syndrome
Statistics
Due to SCAD being a fairly new area of research, it is difficult to report on the burden of SCAD on the population.
The Victor Chang Institute suggests that around SCAD is the cause of 24% of cases of Heart Attacks in women aged less than 50, as well as accounting for 2-4% of the overall presentation of Acute Coronary Syndrome (where there is a sudden loss of blood flow to the heart).
Research also suggests that it is the main cause of Heart Attacks in pregnant women, occurring in 43% of cases.
Signs and Symptoms of SCAD
The signs and symptoms of SCAD can be similar to those of a heart attack, all of which require urgent medical attention:
- Chest pain
- Arm, jaw or shoulder pain
- Shortness of breath
- Sweating
- Rapid heartbeat/feelings of a fluttery chest
- Extreme fatigue
- Nausea
- Dizziness
Treatment for SCAD
The treatment for SCAD will depend on your condition, typically depending on factors such as the tear location on your arteries, as well as on the size of the tear.
Typically, medication is the preferred course of treatment. If your SCAD does not heal naturally, treatment options include:
Stenting: If the blood flow in your coronary artery is blocked or you continue to suffer chest pain even when taking medications, you may need a stent (a tiny tube made of mesh) placed inside your coronary artery to help it open and restore blood flow. See coronary angiogram and stenting.
Bypass surgery: Depending on your SCAD condition, your doctor may recommend bypass surgery if you have more than one tear in your arteries, or if other treatments have not yet worked. See Coronary Artery Bypass Graft Surgery.
Medications: There are medications which your doctor may recommend you take. These medications include: medications such as blood-thinners to prevent any clots forming in your torn coronary artery, Aspirin as a prevention for other cardiac issues, cholesterol medications if you have a higher cholesterol reading, blood pressure medications to reduce the pressure on your torn artery as well as medications to manage chest pain. NPS Medicinewise is a free, useful and evidence-based website to find out more about different medications.
Follow-up treatment: Cardiac rehabilitation, reviewing any family medical history to assess if there are any genetic predispositions for SCAD, as well as scans to look at other arteries to prevent new SCADs developing.
What you need to know
Helena’s Story of SCAD
Further information
- Expert Q&As - Spontaneous Coronary Artery Dissection (SCAD)
- Fact sheet- Spontaneous Coronary Artery Dissection (SCAD)
- Paula’s Story of SCAD
- Veronica’s Story of SCAD
- SCAD Spontaneous Coronary Artery Dissection – Mayo Clinic
Useful links
- Grandmother triggers Australian-first study into deadly SCAD heart disorder
- Survivor of deadly heart disease SCAD leads nationwide support campaign
- SCAD: The Heart Attack That’s Striking Young Women
- Is SCAD rare? Or just rarely diagnosed correctly?
- “All the SCAD ladies, put your hands up!”
- SCAD Research
- SCAD Research Australia
- Australian SCAD Survivors Facebook Group