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Spontaneous coronary artery dissection (SCAD)

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Spontaneous coronary artery dissection (SCAD)

Clinical information and links to SCAD resources.

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, SCAD 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. Revascularisation is associated with high failure rates and worse outcomes but may be required for some patients.

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.

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.

  1. Kaddoura R, Cader FA, Ahmed A, Alasnag M. Spontaneous coronary artery dissection: an overview. Postgrad Med J. Nov 20 2023;99(1178):1226-1236. doi:10.1093/postmj/qgad086
  2. Tweet MS, Gulati R, Hayes SN. Spontaneous Coronary Artery Dissection. Curr Cardiol Rep. Jul 2016;18(7):60. doi:10.1007/s11886-016-0737-6
  3. 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
  4. Pristera N, Chaudhury P, Iterson EHV, Cho LS. Spontaneous coronary artery dissection: Principles of management. Cleveland Clinic Journal of Medicine. 2021;88(11):623-630. doi:10.3949/ccjm.88a.20162
  5. Van Damme A, McDermott S, McMurtry S, Kung JY, Gyenes G, Norris C. Secondary Prevention and Rehabilitation for Spontaneous Coronary Artery Dissection: A Systematic Review. Can J Cardiol. Nov 2023;39(11s):S395-s411. doi:10.1016/j.cjca.2023.08.013

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Last updated23 February 2024