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In the past, people believed SCAD was rare. Research now suggests that the issue may be underreporting, meaning that the true number of cases may be higher than people originally thought. Those who develop SCAD do not typically have any risk factors for cardiac disease. They are also often younger than 50 years old and female. With treatment, most people can survive SCAD. This article reviews what SCAD is, its symptoms, risk factors, treatment, and more. A note about sex and gender Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more. What is SCAD Share on PinterestBSIP/Universal Images Group via Getty ImagesSCAD occurs when the innermost layer of the coronary artery (the artery that supplies blood to the heart) suddenly tears without warning, allowing blood to pass into the inner chamber. The trapped blood then bulges inward, causing a blockage. It may also extend the tear, which can lead to a heart attack due to loss of blood. In the past, experts believed that this condition was rare, but newer evidence suggests it may be more common than previously thought. In either case, SCAD can be life threatening and requires immediate medical treatment. Signs and symptoms of SCAD resemble those that people associate with heart attacks. However, unlike a heart attack, about 80% of people seen who have SCAD are “fairly young, healthy, and active.” Biological females have a higher chance of experiencing SCAD, as about 10–15% of cases occur in males. Causes of SCAD SCAD occurs spontaneously and suddenly. Though researchers have not yet defined the exact cause of SCAD, it occurs when a tear appears in the inner layer of the coronary artery. The tear allows blood to flow into a cavity, which creates an abnormal bulge. The bulge in the artery can block blood flow to the heart. Without treatment, this can lead to a heart attack. Symptoms The presentation of SCAD symptoms is similar to those of a heart attack. They can include:chest pain or pressureshoulder painshortness of breath or trouble breathingincreased sweating dizzinesstemporary loss of consciousnessnausea When tested, a person will also likely present with increased levels of cardiac enzymes, which indicate damage to the heart muscle (though these are not specific to SCAD). As with any type of heart attack, recognizing signs quickly and seeking medical attention helps increase survival. An individual experiencing signs of a SCAD heart attack should seek immediate medical attention or call 911. Diagnosis Diagnosis presents a challenge to doctors because people often lack common risk factors of cardiac disease. If a doctor suspects a person may have SCAD, they may perform several diagnostic tests to check for the condition. Testing for SCAD often includes:Coronary angiography: This is often the first tool used for diagnosis. It uses X-rays to look at the blood vessels in a person’s heart.Intracoronary imaging: This is often used when coronary angiography does not conclusively show SCAD. There are no other biomarkers in the blood to indicate SCAD, but a person typically has elevated troponin levels. Some other possible diagnostic tools a doctor may use include:checking a person’s vital signs such as blood pressure and heart ratean EKGcardiac catheterizationan echocardiogram Treatment SCAD resembles a heart attack, but it requires a different treatment plan. Due to limited knowledge about the condition, there is no standard treatment plan for a doctor to follow. Instead, a doctor will need to assess the location of the tear as well as the person’s symptoms. Doctors often prefer conservative therapies, such as medications, to more invasive methods, such as stent placement. However, they may recommend the following:Revascularization: Due to risks of complications, a doctor will likely only recommend this procedure if necessary.Device implantation: A doctor may recommend the implantation of a cardioverter defibrillator or a mechanical left ventricular assist device for more serious cases.Medications: Studies do not definitively support the use of any specific medications. However, a doctor may recommend statin therapy, beta-blockers, or long-term aspirin. People may also require a heart transplantation. Risk factors Often, a person will not know they have SCAD until they experience a heart attack. They also may not suspect any issues because people who often develop SCAD do not typically have the risk factors associated with heart disease or heart attack. According to a 2018 study, risk factors for SCAD may include being biologically female and being pregnant. Some other risk factors may include:high blood pressureextreme physical exertionsmokingdrug misuseextreme emotional distressliving with an autoimmune diseaseliving with fibromuscular dysplasiaexperiencing issues with blood vessels Complications Without treatment, SCAD can lead to major complications. These can include:blocked blood flow to the heartheart failurearrhythmiacardiac-related death Outlook With prompt medical attention, a person will likely survive SCAD. However, they will often need continued monitoring due to the risk of relapse. About 1–5% of people who develop SCAD will not survive it, with another 14% needing hospitalization to treat the condition. Females, particularly those who are postpartum, tend to have a worse outlook than others. Summary SCAD is a spontaneous, sudden break in the inner wall of the coronary artery. When it occurs, it can cause a person to have a heart attack and can lead to death. A person who has SCAD does not typically have the warning signs and risk factors associated with heart disease. They also tend to be younger than those who are typically most at risk of a heart attack. Females are more likely to develop SCAD than males. With treatment, most people recover from SCAD, though they have a higher chance of developing it again than someone who has never had SCAD.Heart DiseaseCardiovascular / Cardiologyheartvalvedisorders 5 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Coronary artery dissection: Not just a heart attack. (2015). https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks/coronary-artery-dissection-not-just-a-heart-attackHayes, S. N., et al. (2018). Spontaneous coronary artery dissection: Current state of the science: A scientific statement from the American Heart Association. https://www.ahajournals.org/doi/10.1161/cir.0000000000000564Parekh, J. D., et al. (2021). Coronary artery dissection. https://www.ncbi.nlm.nih.gov/books/NBK459203/Parsa, A., . (2019). Spontaneous coronary artery dissection: Clinical considerations in diagnosis and treatment. https://www.acc.org/latest-in-cardiology/articles/2019/12/20/11/41/spontaneous-coronary-artery-dissectionSpontaneous coronary artery dissection. (n.d.).https://www.rwjbh.org/treatment-care/heart-and-vascular-care/diseases-conditions/spontaneous-coronary-artery-dissection/FEEDBACK:By Jenna Fletcher on May 25, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhat is the normal range for troponin levels?Medically reviewed by Lauren Castiello, RN Troponin levels in the blood are usually very low. Very high levels usually indicate that a person has recently had a heart attack. Learn more here.READ MOREHow to spot and treat a heart attackMedically reviewed by Joyce Oen-Hsiao, MD, FACC Here, learn to recognize a heart attack and what to do next. 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