Spontaneous Coronary
Artery Dissection 

Spontaneous coronary artery dissection creates blockages in your heart. It’s different from atherosclerosis—the build-up of fatty deposits in your blood vessels and the most common cause of blocked arteries.

SCAD is a split in the wall of one of your heart’s arteries. This tear creates a loose flap of tissue that can hang down into your artery, blocking blood flow. The separation also lets blood collect between the layers of the artery wall. Over time, a blood clot can form and narrow your artery.

Reduced blood flow from spontaneous coronary artery dissection can cause acute coronary syndrome (ACS). ACS includes a range of heart conditions that cause severe chest pain and discomfort. SCAD can also lead to a heart attack or sudden death if you don’t get timely treatment.

Spontaneous coronary artery dissection can affect anyone at any age, but it’s most common among women in their 40s and 50s. Most people who have SCAD don’t have typical heart disease risk factors like diabetes, high blood pressure or high cholesterol. 

At Emory Heart & Vascular, we bring together a multidisciplinary team to treat spontaneous coronary artery dissection. Our goal is to improve your blood flow, manage your pain and prevent another SCAD event. Our experts offer a full range of treatments to help you.

Our specialists will prescribe medications and suggest lifestyle changes as they closely monitor your condition.

Rarely, surgery is required. Learn more about heart surgery at Emory Healthcare.

Spontaneous coronary artery dissection symptoms can feel like a heart attack—even if you’re not having a heart attack. Talk with your doctor if these signs appear:

• Chest pain or pressure
• Dizziness
• Excessive sweating
• Extreme fatigue
• Nausea
• Pain in your arms, back, jaw or shoulder
• Rapid or fluttery heartbeat
• Shortness of breath
• Vomiting 

We don’t know the underlying cause behind spontaneous coronary artery dissection. But, several factors can increase your risk.

SCAD risk factors include:

• Being female
• Connective tissue genetic conditions: SCAD occurs more often in people who have Ehlers-Danlos or Marfan syndrome.
• Childbirth: SCAD can occur during pregnancy or in the first few weeks after delivery. It may be caused by hormonal changes and stress on your blood vessels.
• Fibromuscular dysplasia (FMD): This condition weakens your mid-sized arteries. It affects females more than males.
• High blood pressure: Severe blood pressure increases your SCAD risk.
• Illegal drug use: Cocaine and other illegal drugs may increase your SCAD risk.
• Stress: Extreme stress can trigger SCAD. This can include significant emotional distress or intense physical activity or exercise. 

Many people don’t know they have—or are at risk for—spontaneous coronary artery dissection. So, it is usually diagnosed in an emergency setting. Cardiovascular experts at Emory Healthcare use leading-edge technologies and advanced therapies to diagnose this complex condition.

Many of the tests that diagnose a heart attack can also detect SCAD:

• Blood tests: Blood tests can check for certain heart proteins that leak into your blood after a heart attack.
• Coronary angiogram: This test examines the inside of your arteries. It captures 3D, real-time pictures of your blood flow. This exam can diagnose SCAD and twisted arteries that may slow blood flow.
• Electrocardiogram (ECG/EKG): This test measures your heart’s electrical activity. It can also detect how fast or slow your heart is beating.
• Intravascular ultrasound: This imaging test gives our experts a clear view of the inside of your arteries.
• Optical coherence tomography: This exam uses light to see inside your blood vessels. Our experts place a thin, flexible tube (a catheter) inside your blood vessel. They shine a light from the catheter to examine your blood vessels from the inside out. 

Our team s proud to be the only program in Georgia to have earned the ACC Accreditation Services Transcatheter Valve Certification. ACC Accreditation Services awards certifications to programs that are committed to continuous improvement and collaboration leading to high-quality care that delivers better outcomes for patients.

We also have a unique partnership with the National Institutes of Health that allows for rapid concept development, testing on animals and compassionate care options for patients who have run out of alternatives. Our innovative procedures give hope to patients who may have been told they have no options.