Spontaneous coronary artery dissection (SCAD) occurs when a split or separation suddenly develops between the layers of the wall of one of the blood vessels (artery) that provides blood flow to the heart.
The space between the layers of the artery wall may fill with blood, causing a haematoma, which may reduce or block flow through the artery; or a flap of loose tissue from the dissection may create a blockage.
If not diagnosed and treated quickly, SCAD may lead to a heart attack or life-threatening arrhythmias. Although rare, SCAD is increasingly identified as a cause of acute coronary syndrome (ACS), most frequently in women with few or no cardiac risk factors.1
In an Australian study of SCAD, 23 percent of ACS events in women under 60 were attributed to SCAD.2
There are currently no evidence-based consensus guidelines on the management of SCAD but conservative therapy has been typically associated with spontaneous healing and is now advocated as the management strategy of choice. Revascularisation is associated with high failure rates and worse outcomes but may be required for some patients.
Because SCAD mostly affects women with few traditional risk factors, awareness of and quick response to the warning signs of a heart attack is important advice for all women.
On discharge from hospital, every patient with a heart condition should be referred to a cardiac rehabilitation program to start them on the road to recovery and ongoing management of their condition.
More information on SCAD can be found at Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement from the American Heart Association
Patients can access more information about SCAD below.
Position statement: Coronary artery calcium scoring for the primary prevention of cardiovascular disease in Australia.
Guidelines for the prevention, detection and management of heart failure in Australia, for health professionals including general practitioners, cardiologists, cardiothoracic surgeons, nurses, pharmacists, and other allied health professionals.
Resources and tools for healthcare professionals to support the management of patients with heart failure.
Last updated23 February 2024