Spontaneous Coronary Artery Dissection (SCAD)

Spontaneous Coronary Artery Dissection (SCAD) occurs when a split or separation suddenly develops between the layers of the wall of one of the blood vessels (artery) that provides blood flow to the heart.

The space between the layers of the artery wall may fill with blood, causing a haematoma, which may reduce or block flow through the artery; or a flap of loose tissue from the dissection may create a blockage.

If not diagnosed and treated quickly, SCAD may lead to a heart attack or life-threatening arrhythmias.
Although rare, Spontaneous Coronary Artery Dissection is increasingly identified as a cause of Acute Coronary Syndrome (ACS), most frequently in women with few or no cardiac risk factors [1]. In an Australian study of SCAD, 23 percent of ACS events in women under 60 were attributed to SCAD [2].

There are currently no evidence-based consensus guidelines on the management of SCAD but conservative therapy has been typically associated with spontaneous healing and is now advocated as the management strategy of choice [2].

Because SCAD mostly affects women with few traditional risk factors, awareness of and quick response to the warning signs of a heart attack is important advice for all women.

On discharge from hospital, every patient with a heart condition should be referred to a cardiac rehabilitation program to start them on the road to recovery and ongoing management of their condition [3].

More information on SCAD can be found at Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement from the American Heart Association

Information for your patients

Patients can access more information about SCAD below.

• Video: Jen had a spontaneous coronary artery dissection (SCAD) at 36, shortly after having her first child. 
• Video: Learn more about Liza's experience of Spontaneous Coronary Artery Dissection. 
• Video: Spontaneous Coronary Artery Dissection - the little known face of heart disease.
• SCAD Research website
• Warning signs of a heart attack

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[1] Nishiguchi et al 2016. Prevalence of spontaneous coronary artery dissection in patients with acute coronary syndrome. European Heart Journal, vol. 5, issue 3.
[2] Rashid HN et al. Incidence and characterisation of spontaneous coronary artery dissection as a cause of acute coronary syndrome: a single-centre Australian experience. Int J Cardiol. 2016; 202:336-338.
[3] Heart Foundation. Improving the delivery of cardiac rehabilitation in Australia. The heart Foundation’s Cardiac Rehabilitation Advocacy Strategy. Heart Foundation: 2014.