Spontaneous Coronary Artery Dissection (SCAD) - MedStar Heart and Vascular Institute

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A rare and dangerous condition that causes artery tissues to separate

The wall of the coronary artery has three thin layers of tissue. In spontaneous coronary artery dissection (SCAD), these layers can tear and separate. Blood seeps between the layers and becomes trapped, bulging the wall of the artery inward and blocking blood flow to the heart. This blockage can cause a heart attack.

The experts on our interventional cardiology and cardiac surgery teams are equipped with the latest research and technology to know what it takes to provide lifesaving care for this condition.

What are the symptoms of spontaneous coronary artery dissection?

A heart attack often is the first symptom people with this condition notice. Other symptoms are the same as those of a heart attack, including chest pain, dizziness, rapid heartbeat, and unusual tiredness. Call 911 right away if you notice any of these symptoms.

Risk factors

It’s not clear what causes spontaneous coronary artery dissection, but researchers think the following factors can increase a person’s risk for developing the condition:

  • Diseases of the connective tissue, such as Marfan syndrome

  • Female gender, though the disease does affect men

  • Fibromuscular dysplasia, a condition that causes abnormal cell growth in the arteries

  • High blood pressure

  • Intense or extreme exercise
  • Pregnancy or having recently given birth
  • Serious emotional stress

Tests

Testing for this condition is similar to testing for other forms of heart attack, including blood tests and an electrocardiogram. You also may need one of several tests to take pictures of your arteries.

Cardiac Catheterization

Cardiac catheterization is a minimally invasive way to diagnose and treat a variety of heart and vascular conditions by guiding thin, flexible tubes called catheters through blood vessels to problem areas.

Computerized Tomography (CT) Scan 

The cardiac computed tomography scan, or cardiac CT, uses X-rays to create three-dimensional images of your heart and blood vessels.

Echocardiogram

An echocardiogram uses high-frequency sound waves to create images of your heart.

Electrocardiogram (ECG)

An electrocardiogram, also known as an ECG, measures the heart’s electrical activity.

Fractional Flow Reserve

Fractional flow reserve, also known as FFR, is a measurement of how well blood can flow through the coronary arteries. Narrowing or blockages in these arteries can lead to a heart attack without treatment.

Stress Tests

Stress tests are used to assess how your heart works during physical activity. There are several types of stress tests, including treadmill or bike stress tests, nuclear stress tests, stress echocardiograms, and chemically induced stress tests.

Treatments

Your doctor may recommend letting the tear in your artery heal on its own or medication to reduce the risk of blood clots. If these don’t help, or if your heart isn’t getting enough blood, you may need a stent or a coronary artery bypass.

Coronary Artery Bypass Surgery

Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG) surgery, restores normal blood flow through narrowed or blocked coronary arteries by using a healthy blood vessel taken from your leg, arm or chest to create a detour around the problem area.

Coronary Artery Stenting

Coronary artery stents are small mesh tubes placed within the artery to prevent blockages and allow better blood flow.

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