Spontaneous Coronary Artery Dissection (SCAD) in Women

Spontaneous coronary artery dissection (SCAD) is an emergency that happens when a tear forms inside the wall of an artery in your heart. A blood clot or a flap inside the artery slows down blood flow through it. It can cause a heart attack, heart rhythm problems, or even death without quick treatment.

SCAD in Women

SCAD mostly affects women, who make up about 95% of cases. In fact, SCAD tends to affect younger, otherwise healthy women who don’t have high blood pressure or high cholesterol.

SCAD often goes unnoticed because:

• Most women with SCAD don't have the usual heart disease risk factors
• The symptoms appear similar to those of less serious conditions

This can lead to dangerous delays in diagnosis and treatment.

SCAD Treatment at UVA Health

At UVA Health, our heart and vascular team offers the kind of deep training and experience you can count on. We make sure you get the thorough, expert attention you deserve.

In fact, U.S. News & World Report ranked 5 of our heart treatment services as "high-performing," which means they're some of the best in the U.S. And we've received several other awards for our leading-edge care.

Our SCAD care is part of our Women’s Heart Health Care program, which offers you heart testing and complete care that goes beyond the standard. We combine advanced imaging with a check of your risk factors, like pregnancy complications, autoimmune diseases, breast cancer treatment, and early menopause.

SCAD: Symptoms & Diagnosis

SCAD is often triggered by emotional or physical stress, postpartum hormonal changes, or intense exertion. It can also cause symptoms that aren’t typical of a heart attack.

Some warning signs of SCAD may include:

• Chest pain or pressure
• Dizziness
• Extreme fatigue
• Pain in parts of the upper body, like the back and shoulders
• Rapid heartbeat
• Shortness of breath
• Unusual sweating

Because it isn’t caused by plaque buildup, signs of SCAD don’t always show up on standard tests. In fact, procedures like coronary angiography may make the tear in the artery wall worse, especially during pregnancy.

That’s why our experts use safer, more precise tools like heart CT and MRI to evaluate and diagnose.  

What Causes SCAD?

The exact cause of SCAD isn’t known. Your risk for SCAD may be higher if you have:

• A history of spontaneous coronary artery dissection
• Artery abnormalities
• Dangerously high blood pressure
• Genetics
• Hormonal imbalances
• Inflammation
• Substance use disorders

Many people who get SCAD also have fibromuscular dysplasia (FMD).