Spontaneous Coronary Artery Dissection (SCAD): A Patient Guide

IF YOU HAVE SYMPTOMS NOW: Call emergency services (911) for new or concerning chest pain, breathing difficulties, fainting, severe neurologic symptoms, or sudden severe headaches. Do not use this guide to triage an active medical event.

Spontaneous Coronary Artery Dissection (SCAD) is a sudden and often life-changing heart event that occurs when a tear or a bruise develops within the wall of a coronary artery. Unlike a typical heart attack caused by the gradual buildup of plaque or cholesterol, SCAD is a structural failure of the blood vessel itself ^[1]. This internal bleeding creates a “false” channel that compresses the “true” path of blood flow, starving the heart muscle of oxygen and causing the same symptoms as a traditional heart attack. Because it frequently strikes individuals who are young, active, and lack traditional heart disease risk factors, the diagnosis often comes as a profound shock to both the patient and their family ^[2][3].

The management of SCAD differs significantly from the standard protocols used for plaque-based heart disease. While doctors often urgently place stents or perform surgery for a typical heart attack—a lifesaving intervention for atherosclerotic disease—the fragile nature of a dissected artery means that these invasive procedures can sometimes worsen the SCAD injury ^[4]. In most cases, if a patient is medically stable, the preferred treatment is conservative management—allowing the body to use its natural ability to heal the artery wall over several weeks or months ^[5][6]. Medications are then used primarily to lower the “shear stress” on the vessel, keeping blood pressure and heart rate low to provide the artery with a quiet environment in which to recover ^[7].

Living with SCAD requires a focus on the health of your entire vascular system, as the condition is often associated with underlying arterial vulnerabilities. The most common of these is Fibromuscular Dysplasia (FMD), a condition affecting the structure of artery walls throughout the body ^[8]. Consequently, a comprehensive “head-to-pelvis” imaging scan is commonly recommended by expert consensus as a part of the journey to evaluate whether other major vessels have abnormalities ^[9]. Additionally, for those whose SCAD was associated with pregnancy or extreme hormonal shifts, a specialized, multidisciplinary care team is essential to navigate the complexities of long-term wellness and future family planning ^[10].

As you move forward, learning to interpret your body’s signals is one of the most important aspects of recovery. Recurrent chest pain is very common during the healing process and can be a significant source of anxiety, yet it is vital to know the “red flag” symptoms that require an immediate return to emergency care ^[11][12]. While the road to recovery involves physical and emotional hurdles, and healing depends on individual anatomy and heart function, many survivors return to full, active lives ^[13]. By working with a care team that understands the unique nature of your heart, you can focus on healing and regaining confidence in your body’s strength ^[14].

Note on evidence limits: Because large randomized trials are limited for this rare condition, many SCAD recommendations are drawn from observational registries and expert consensus statements. (Last updated: October 2026).

Quick Glossary of Terms

• ACS (Acute Coronary Syndrome): A sudden reduction in blood flow to the heart (a heart attack).
• FMD (Fibromuscular Dysplasia): A non-atherosclerotic arterial disease causing abnormal structure in blood vessel walls.
• PCI (Percutaneous Coronary Intervention): Stent placement.
• CABG: Coronary Artery Bypass Grafting (bypass surgery).
• DAPT: Dual Antiplatelet Therapy (e.g., Aspirin plus clopidogrel).
• CTA / MRA: Computed Tomography Angiography / Magnetic Resonance Angiography (high-resolution vascular imaging).