The coronary arteries come from the aorta and spread out over the surface of your heart like the branches of a tree, supplying your heart with oxygen and nutrients. The walls of the arteries are made up of 3 layers (an inner, middle and outer layer)
SCAD is an uncommon emergency condition in which a ‘tear’ happens within the layers of the wall of the artery. This leads to blood becoming trapped within the artery, forming a clot and causing a partial or complete blockage. This can lead to a possible heart attack, an abnormal heart rhythm or even sudden death, if not treated promptly.
The symptoms are very similar to those of angina or a heart attack, these include;
Researchers are not fully sure what causes SCAD, but it is known that 80% of sufferers are women and 30% of those are nearing the end of a pregnancy or have recently given birth.
Most people with SCAD are otherwise healthy and might not have any risk factors for heart disease. It tends to occur in people between the ages of 19 to 64 years.
Other possible causes include:
Unfortunately, unlike coronary heart disease, it doesn’t seem to be preventable and happens out of the blue.
SCAD is a difficult condition to diagnose because it doesn’t have any warning signs prior to causing angina or a heart attack.
Coronary angiography may recognise the signs of SCAD, however, intravascular ultrasound or specialised screening is necessary for a definitive diagnosis.
The aim of treatment in SCAD is to restore blood flow to the heart muscle.
The most appropriate treatment will depend on the severity of the tear, its location, and of course your signs and symptoms.
If possible, allowing the tear to heal naturally, without any invasive procedures is ideal. Management using medications alone that can control blood pressure is often preferred. In some people, coronary stenting can also be used to restore blood flow to the heart. In some cases, bypass surgery may be necessary. However, the risk of complications is higher and the success rate lower.
Cardiac rehab is a very important part of SCAD recovery, especially if you were fit and well prior to the cardiac event. Loss of confidence is very common, and so exercising in a safe, controlled environment, is highly beneficial.
Risk of Recurrence
SCAD can recur, usually in a different coronary artery, so it is important to be aware of any signs or symptoms and act promptly. Lifestyle modifications to reduce pressure on the heart and coronary arteries should be adhered to.
The Irish Heart Foundation offers a range of free support services to those affected by heart disease or stroke that can greatly improve their quality of life. These include support groups, physical exercise classes, therapy sessions and more.
For more information on these supports, see our Patient Supports page.
If you have any questions about heart disease or stroke, you can also call the Irish Heart Foundation’s Nurse Support on (01) 668 5001 to speak to a nurse specialist who will answer your questions, and give you guidance and reassurance.
Angioplasty and Angiogram – our guides from symptoms to treatment
Step by Step through Heart Attack – our patient information booklet
Angina – our guide from symptoms to treatment
Heart & Stroke Conditions A-Z – see our range of guides.
Your Heart Health – view our articles on ways to manage and reduce your risk factors, from being active to stress, cholesterol, losing weight, blood pressure and more.
Spontaneous Coronary Artery Dissection (SCAD) information booklet