What is SCAD?

Spontaneous Coronary Artery Dissection (SCAD) is an under-diagnosed heart condition that can’t currently be predicted or prevented.

SCAD has been reported across a wide age range (18-84 years) but the majority of cases are in young- to middle-aged women. SCAD patients have few or none of the traditional risk factors associated with heart disease (atherosclerosis). More research is needed to understand why fit, healthy people suddenly develop SCAD.

SCAD can be fatal, cause heart failure, cardiac arrest, require heart bypass surgery, stents or medical management.

SCAD occurs when a tear or a bruise develops in one of the coronary arteries resulting in a blockage that prevents normal blood flow. This can result in a heart attack.

We don’t yet know what causes SCAD. Some associations have been described with:

  • Pregnancy and post-partum
  • Menopause
  • Fibromuscular Dysplasia (FMD)
  • Connective tissue disorders
  • Extreme stress
  • Extreme exercise or emotional stress

Read more about current knowledge and emerging theories in the European Society of Cardiology SCAD Position Paper.

Watch this video where Dr David Adlam, who is leading the UK research, explains more about SCAD.

We asked Dr Adlam if SCAD always causes a heart attack?

He told us: It depends on definitions – the overwhelming majority of SCAD patients will present with an acute event (sudden onset) and there will be a rise in the cardiac enzymes which are an indicator of a heart attack. There are some patients who don’t seem to have a rise, but in most cases the patients’ presentation is some time after the event. In this cardiac MRI study, there were 40% of patients where there was no demonstrable injury in terms of a scar. So many of the patients who have the smaller event will not have a persisting heart injury of any size that will be important going forward in terms of the heart function.

There is a lot of medical jargon associated with the heart and SCAD, so have a look at our Jargon Buster for explanations.