Print OverviewSpontaneous coronary artery dissection is an emergency condition that occurs when a tear forms in a wall of a heart artery. Spontaneous coronary artery dissection also is called SCAD. SCAD can slow or block blood flow to the heart, causing a heart attack, heart rhythm problems or sudden death. SCAD most commonly affects women in their 40s and 50s, though it can occur at any age and can occur in men. People who have SCAD often don't have risk factors for heart disease, such as high blood pressure, high cholesterol or diabetes. SCAD can cause sudden death if it isn't treated promptly. Get emergency medical help if you have heart attack symptoms — even if you think you aren't at risk of a heart attack. Spontaneous coronary artery dissection (SCAD) Show transcript for video Spontaneous coronary artery dissection (SCAD) A tear develops on the inside of a coronary artery, allowing blood to create a split between two layers of the wall. This may result in a loose flap of tissue on the inside of the artery. Sometimes, the split remains small, but the blood in between the layers can clot. This clot, called an intramural hematoma, may cause the normal artery channel to become narrow, blocking blood flow to the heart. SymptomsSymptoms of SCAD can include: Chest pain or pressure. Pain in the arms, shoulders, back or jaw. Shortness of breath. Unusual sweating. Extreme tiredness. Upset stomach. A rapid heartbeat or fluttery feeling in the chest. Feeling dizzy. When to see a doctorCall 911 or your local emergency number if you have chest pain or think you might be having a heart attack. If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Do not drive yourself unless you have no other choice. Request an appointment CausesThe cause of spontaneous coronary artery dissection is unknown. Risk factorsRisk factors for SCAD include: Being female. SCAD can happen to anyone. But it tends to affect women more than men. Childbirth. Some women who have had SCAD have recently given birth. This may be due to changes in hormones and stress on the blood vessels. SCAD has been found to occur most often in the first few weeks after delivery. But SCAD also can occur during pregnancy. Extreme stress. SCAD can happen after extreme stress. This includes intense physical exercise and severe emotional distress. Fibromuscular dysplasia (FMD). This condition causes weakening of the body's medium-sized arteries. FMD may lead to artery problems such as aneurysm or dissection. Women are more likely to have it than men. Genetic conditions affecting connective tissue. Ehlers-Danlos and Marfan syndromes have been found to occur in people who have had SCAD. Very high blood pressure. Severe high blood pressure can raise the risk of SCAD. Illegal drug use. Using cocaine or other illegal drugs might increase the risk of SCAD. Complications Blood flow in arteries in spontaneous coronary artery dissection (SCAD) Enlarge image Close Blood flow in arteries in spontaneous coronary artery dissection (SCAD) Blood flow in arteries in spontaneous coronary artery dissection (SCAD) In spontaneous coronary artery dissection, also called SCAD, a tear forms in an artery in the heart. This can cause blood to pool in the area between the layers. SCAD can reduce or block blood flow through the artery, which can cause a heart attack. A heart attack as a result of SCAD is different from a heart attack caused by atherosclerosis. A possible complication of SCAD is heart attack. SCAD slows or stops blood flow through an artery. This weakens the heart and may lead to a heart attack. A heart attack from SCAD is different from a heart attack caused by a buildup of fats, cholesterol and other substances in and on the artery walls. This condition is called atherosclerosis. In some people with SCAD, the inner and outer layers of the artery may split. Blood can collect between these layers. Pressure from the pooled blood can make SCAD worse. Even with successful treatment, SCAD can happen more than once. It might happen soon after the first episode or years later. People who have SCAD also may have a higher risk of other heart problems. These problems include heart failure due to the heart attack damage. By Mayo Clinic Staff Spontaneous coronary artery dissection (SCAD) care at Mayo Clinic Request an appointment Diagnosis & treatment Sept. 16, 2023 Print Living with spontaneous coronary artery dissection (scad)? Connect with others like you for support and answers to your questions in the Heart & Blood Health support group on Mayo Clinic Connect, a patient community. Heart & Blood Health Discussions I have a very high calcium score. What next? 364 Replies Tue, Nov 12, 2024 chevron-right Is Low Diastolic Blood Pressure common with Stage 3 or 4 CKD? 160 Replies Sun, Nov 10, 2024 chevron-right Important information about statins that I’m going to ask my doc about 191 Replies Wed, Nov 06, 2024 chevron-right See more discussions Show references Saw J. Spontaneous coronary artery dissection. https://www.uptodate.com/contents/search. Accessed May 3, 2023. AskMayoExpert. Spontaneous coronary artery dissection (SCAD). Mayo Clinic; 2022. Hayes SN, et al. Spontaneous coronary artery dissection: JACC state-of-the-art review. Journal of the American College of Cardiology. 2020; doi.org/10.1016/j.jacc.2020.05.084. Kim ESH. Spontaneous coronary-artery dissection. The New England Journal of Medicine. 2020; doi:10.1056/NEJMra2001524. Barbieri L, et al. Optical coherence tomography and coronary dissection: Precious tool or useless surplus? Frontiers in Cardiovascular Medicine. 2022; doi: 10.3389/fcvm.2022.822998. RadiologyInfo.org. Intravascular ultrasound. https://www.radiologyinfo.org/en/info/ultrasound-intravascular. Accessed May 8, 2023. American Heart Association. Life's essential 8: Your checklist for lifelong good health. https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks/coronary-artery-dissection-not-just-a-heart-attack. Accessed May 10, 2023. American Heart Association. Coronary artery dissection: Not just a heart attack. https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks/coronary-artery-dissection-not-just-a-heart-attack. Accessed May 15, 2023. Teruzzi G, et al. Spontaneous coronary-artery dissections: A systemic review. Journal of Clinical Medicine. 2021; doi:10.3390/jcm10245925. Ami TR. Allscripts EPSi. Mayo Clinic. May 3, 2023. Related Blood flow in arteries in spontaneous coronary artery dissection (SCAD) Cardiac catheterization procedure approaches Heart with tortuous coronary arteries Hidden Heart Attack SCAD 2 Social Media as a Lifesaving Link Spontaneous coronary artery dissection (SCAD) Show more related content Associated Procedures Cardiac catheterization Cardiac rehabilitation Coronary angiogram Coronary angioplasty and stents Coronary artery bypass surgery CT coronary angiogram X-ray Show more associated procedures News from Mayo Clinic Mayo Clinic Minute: Hope for spontaneous coronary artery dissection, SCAD Feb. 22, 2023, 04:00 p.m. CDT Mayo Clinic in Rochester, Minnesota, has been recognized as one of the top Cardiology & Heart Surgery hospitals in the nation for 2024-2025 by U.S. News & World Report. 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