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Spontaneous coronary artery dissection (SCAD)

Spontaneous coronary artery dissection — sometimes referred to as SCAD — is a rare emergency condition that occurs when a tear forms in one of the blood vessels in the heart.

Spontaneous coronary artery dissection (SCAD) can slow or block blood flow to the heart, causing a heart attack, abnormalities in heart rhythm and sudden death.

Spontaneous coronary artery dissection (SCAD) tends to affect people ages 30 to 50, though it can occur at any age. People who develop spontaneous coronary artery dissection (SCAD) are often healthy, and many don't have risk factors for heart disease, such as high blood pressure and diabetes.

Spontaneous coronary artery dissection (SCAD) can lead to sudden death if it isn't diagnosed and treated promptly. For this reason, seek emergency attention if you experience heart attack signs and symptoms — even if you think you aren't at risk for a heart attack.

Symptoms Causes Risk factors Complications

Signs and symptoms of spontaneous coronary artery dissection (SCAD) include:

  • Chest pain
  • A rapid heartbeat or fluttery feeling in the chest
  • Pain in your arms, shoulders or jaw
  • Shortness of breath
  • Sweating
  • Unusual, extreme tiredness
  • Nausea
  • Dizziness

When to see a doctor

If you experience chest pain or suspect you're having a heart attack, immediately call 911 or your local emergency number. If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last resort.

It's not clear what causes spontaneous coronary artery dissection (SCAD).

Spontaneous coronary artery dissection (SCAD) causes a superficial tear inside an artery. When the inner layers of the artery separate from the outer layers, blood can pool in the area between the layers. The pressure of the pooling blood can make a short tear much longer. And blood trapped between the layers can form a blood clot.

Spontaneous coronary artery dissection (SCAD) may slow blood flow through the artery to the heart, which makes the heart work harder. Or blood flow through the artery can be completely stopped, causing heart muscle to die (heart attack).

Doctors and researchers have found some similarities among people who have experienced spontaneous coronary artery dissection (SCAD). It's not yet clear what role these factors play in causing the disease. Common factors include:

  • Female sex. Though spontaneous coronary artery dissection (SCAD) can occur in both men and women, it tends to affect women more often.
  • Giving birth. Some women with spontaneous coronary artery dissection (SCAD) have recently given birth. Spontaneous coronary artery dissection (SCAD) was found to occur most often in the first few weeks after delivery.
  • Irregular growth of cells in the artery walls. A condition called fibromuscular dysplasia (FMD) causes the irregular growth of cells in the walls of one or more of your arteries. This irregular growth can weaken the artery walls and reduce blood flow. FMD can also cause high blood pressure, a stroke and tears in other blood vessels. FMD occurs more often in women than it does in men.
  • Extreme physical exertion.
  • Blood vessel problems. Diseases that cause inflammation of the blood vessels, such as lupus and polyarteritis nodosa, have been associated with spontaneous coronary artery dissection (SCAD) .
  • Inherited connective tissue diseases. Genetic diseases that cause problems with the body's connective tissues, such as Ehlers-Danlos syndrome and Marfan syndrome, have been found to occur in people with spontaneous coronary artery dissection (SCAD).
  • Very high blood pressure. Having untreated, severe high blood pressure is associated with spontaneous coronary artery dissection (SCAD).
  • Cocaine use.

In some people, spontaneous coronary artery dissection (SCAD) can occur again, despite successful treatment. It may recur soon after the initial spontaneous coronary artery dissection (SCAD) or years later.

Doctors are studying why spontaneous coronary artery dissection (SCAD) recurs and who is most likely to experience a recurrence.

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