• By Ian Roth

Mayo Clinic Minute: What is spontaneous coronary artery dissection?

February 22, 2018

Patients who suffer from a type of heart attack that affects mainly younger women may benefit most from conservative treatment, letting the body heal on its own, according to a new scientific statement from the American Heart Association that published in its journal, Circulation.

Spontaneous coronary artery dissection, or SCAD, is a kind of heart attack. But it's also a silent killer that victims don't see coming because it's unlike most traditional perceptions of heart attacks.

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It's not due to plaque buildup in the arteries," says Dr. Sharonne Hayes, a Mayo Clinic cardiologist. "It typically happens in young people, particularly women."

Dr. Hayes says it happens when a tear develops inside the 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, sometimes, blood flows in between the layers and can clot, which causes the artery to narrow and can sometimes block blood flow to the heart.

"We don't really know the cause, although it is associated with certain blood vessel abnormalities, giving birth, extreme exercise, or excitement or emotion," Dr. Hayes says.

Research shows it could be related to family genetics, too.

The symptoms are similar to other kinds of heart attack: chest pain, rapid heartbeat, shortness of breath, sweating, extreme tiredness, nausea and dizziness.

Dr. Hayes was chair of the writing group for the new scientific statement from the American Heart Association. She says the statement is an overview of what an international group of experts know about spontaneous coronary artery dissection:

  • Risk factors
  • Its high rate of recurrence
  • Its association with women, pregnancy, and physical and emotional stress triggers
  • Its connection to other diseases of the arteries, such as fibromuscular dysplasia
  • The best diagnosis and treatment recommendations based on new evidence and experts’ care of spontaneous coronary artery dissection patients

Learn more about the scientific statement on spontaneous coronary artery dissection.

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