A coronary artery dissection is a serious heart condition that requires emergency treatment. This condition happens when one of the arteries in the heart develops a tear in its inner lining — one of the artery’s three walls.

One type of coronary artery dissection is called a spontaneous coronary artery dissection (SCAD). This happens when the tear in the inner lining causes blood to build up between the layers. This can cause a blood clot to form, blocking blood flow to the heart muscle. The blood clot can also grow as platelets and other substances build up.

This type of dissection sometimes occurs in the aorta, the large artery that delivers blood from the heart to most of the body. When it does, the condition is called an aortic dissection.

SCAD occurs more often in women who are over 50 years old or postmenopausal, according to a 2015 review. But it is also a common cause of heart attack in women before menopause. Research from 2014 suggests that aortic dissection is most common among men in their 60s and 70s. But both conditions can develop in anyone at any age.

SCAD symptoms, causes, and treatments are explained in this article.

Symptoms of aortic dissection and SCAD are similar to signs of a heart attack, and include:

  • There is chest pain.
  • The breath was very thin.
  • There is pain in one or both arms.
  • There is pain in the shoulders, neck, and jaw.
  • sweat is cold
  • nausea
  • dizziness

Sudden, severe There is chest pain. and The breath was very thin. should always be treated as medical emergencies — even if other symptoms aren’t present or don’t seem as serious.

When to seek emergency medical help

If you believe you or a loved one is having a heart attack, call the emergency services.

The pain associated with an aortic dissection, as opposed to SCAD or a heart attack, can feel like something is tearing or splitting inside your chest.

Heart attack pain is often described as a pressure, heaviness, or tightening sensation.

A heart attack and symptoms of a stroke are both similar to a aortic dissection.

  • There is weakness on one side of the body.
  • Difficult speaking or understanding.
  • Vision problems.
  • Near fainting, dizziness, or dizziness.

“These are the usual symptoms for these conditions. Symptoms alone can’t diagnose SCAD, Aortic dissection, and heart attack because they overlap.”

Each of these conditions requires immediate medical attention. Doctors at the hospital can conduct a physical exam and run tests to determine the root cause of your symptoms.

According to the American College of Cardiology (ACC), there are three main types of SCAD.

SCAD type Description
type 1 A noticeable flap can be seen using contrast dye and coronary angiography.
type 2 This is the most common type of SCAD, according to a 2017 review. It’s identified by a significant narrowing or obstruction of the affected artery.
type 3 The least common type of SCAD resembles atherosclerosis. It’s actually due to blood collections, but without any narrowing of other coronary arteries, which is typical of traditional atherosclerosis.

The experts divide dissections into two categories based on the location of the tear.

Aortic dissection type Description
type A The most common type usually occurs where the aorta extends outward from the heart.
type B This type occurs in the descending aorta, after it goes from the head down to the legs.

There are known risk factors for SCAD, but it is not always clear why it happens.

For example, a 2021 study found that women are much more likely than men to develop SCAD. Most women who experience SCAD are in their 40s and 50s, but people who are pregnant or recently gave birth are also at higher risk of SCAD.

Men are more likely to have an aortic dissection.

A 2019 study notes that the following conditions raise the risk of both SCAD and coronary artery dissection:

Poorly controlled high blood pressure, attitude, and other conditions are risk factors for SCAD.

SCAD and aortic dissection can be linked to strenuous exercise, particularly weightlifting.

When someone has a heart attack, SCAD is often the first diagnosis. The first steps in a heart attack are listed.

  • an electrocardiogram (EKG) to monitor your heart’s electrical patterns and rhythms
  • a blood test to measure troponin, a protein that’s released into your blood after a heart attack

SCAD is present in about 1 in 4 heart attacks in women under the age of 60. A person with heart attack symptoms may be evaluated for atherosclerosis, a narrowing and stiffening of the arteries. According to the American Heart Association, if no atherosclerosis is found, a doctor should test for SCAD.

Coronary angiography is the main method of diagnosing SCAD. As part of this invasive test, a thin plastic tube called a catheter is placed inside your artery. Through that catheter, a special dye is injected into the bloodstream that can only be detected by X-rays. A coronary angiogram can detect problems with blood flow, and can often show the location of the dissection and its severity.

According to a 2014 study, intravascular ultrasound (IVUS) is often used alongside coronary angiography to confirm a diagnosis of SCAD. This type of imaging can help assess the exact location and extent of a tear in the artery.

IVUS is a catheter-based procedure that occurs under a mild sedative. A small tube with an ultrasound probe on the end is inserted into the heart and guided by your doctor. This probe sends signals to a computer, creating cross-sectional images. These images provide a real-time 360-degree view of the area of the heart being imaged. IVUS is frequently used to guide the placement of a stent to treat blocked arteries.

A dissection of the aortic valve may be diagnosed using one or more of the following tests.

If a doctor determines that your aortic dissection is mild and that no interventions are needed right away, they may prescribe certain medications to lower your blood pressure and slow your heart rate.

Medications to treat mild SCAD also include antihypertensive drugs and blood thinners to lower the risk of a blood clot forming at the site of the tear.

If medications aren’t enough to treat the condition, you may need surgery or a catheter-based procedure aimed at treating the injured artery.

For SCAD, open heart surgery can be performed to bypass the damaged artery with a blood vessel from elsewhere in the body.

A dissection may be repaired. A replacement valve may be needed if the valve in the heart is damaged.

In addition to medical therapy and invasive procedures, the Heart and Stroke Foundation of Canada says that managing a coronary artery dissection or SCAD often means adopting certain heart-healthy behaviors.

Some important lifestyle changes are listed.

  • A doctor will approve regular exercise.
  • Heavy lifting and contact sports are not recommended.
  • Maintaining a moderate weight.
  • following a heart-healthy diet, such as the Mediterranean diet
  • If necessary, you can manage your blood pressure with medications.
  • If you smoke, you can reduce or quit.
  • The stress is lowered.
  • attending cardiac rehabilitation

A 2017 study says that a doctor may recommend taking beta-blockers along with some of these lifestyle changes. Also, visit a cardiologist regularly to monitor your heart health.

Ensuring you have adequate blood flow throughout the body is dependent on healthy arteries.

The heart muscle can suffer if a coronary artery is torn. The consequences of tearing the aorta are fatal without surgery.

“If you get immediate medical help, SCAD and aortic dissection are often treatable. Follow the doctor’s advice on taking and lifestyle changes to prevent further cardiac problems.”