SCAD is a tear inside a heart artery that can cause a heart attack in young, healthy women. Learn how it is found on CT angiography, how it differs from usual blockages and how it is treated.
Spontaneous coronary artery dissection (SCAD) is a sudden tear in the wall of a heart artery, which creates a blood-filled space that can block blood flow and cause a heart attack. It often affects younger women, including those around pregnancy, and not people with the usual cholesterol blockages. SCAD is usually diagnosed during angiography, and CT angiography may help in follow-up or in selected cases.
What Happens in SCAD?
A tear forms in the artery wall, and blood collects between the layers, forming an intramural haematoma that narrows or blocks the artery. The cause is not fully known, but hormonal changes, pregnancy and the postpartum period, connective tissue disorders such as fibromuscular dysplasia, extreme stress or exertion and inflammation are linked. See heart attack warning signs.
FeatureSCADUsual plaque (atherosclerosis) heart attackTypical patientYounger women, often few risk factorsOlder, with risk factorsCauseTear in the artery wallPlaque rupture and clotTreatmentOften medicines; stent only if neededStent or bypass oftenFollow-up imagingCT angiography in selected patientsAs neededRecurrencePossibleDepends on risk controlSymptoms
- Chest pain or pressure, sometimes sudden and severe
- Pain spreading to the arm, jaw or back
- Breathlessness, sweating, nausea or fainting
- Palpitations
These need emergency care in any person, even a young, healthy one.
How Is SCAD Diagnosed?
Emergency ECG, troponin blood tests and coronary angiography are the main tools. Intracoronary imaging (OCT or IVUS) can confirm it. CT angiography can show the arterial wall tear in selected stable patients and is used in follow-up of healing, though small vessels may be hard to assess. Because the artery is fragile, doctors try to avoid unnecessary catheter procedures. See CTCA vs conventional angiography.
Treatment
Most SCADs heal on their own over weeks, so medicines and monitoring are the first choice: beta-blockers, blood pressure control and sometimes aspirin. Stents or bypass are used if blood flow is severely limited or the person is unstable. Statins are used if cholesterol is high. Rehabilitation and heart-friendly habits help recovery.
Associated Conditions and Screening
Many patients with SCAD have fibromuscular dysplasia, which can affect neck and kidney arteries. Doctors may advise CT or MR angiography of the head, neck, chest, abdomen and pelvis to look for it, since it can cause aneurysms. See CT angiography vs MR angiography and CT renal angiography.
A Practical Example
Neelam, 36, a few weeks after delivering her baby, develops sudden chest pain. Angiography shows SCAD in one artery. She is treated with medicines and rest, and a CT angiography after months shows that the artery has healed. She is advised on contraception and blood pressure control, and to discuss future pregnancy with her cardiologist.
After the Scan and Next Steps
Take the report to a cardiologist who has experience in SCAD. Follow the plan on medicines, avoid extreme strain such as heavy lifting for some weeks and join cardiac rehabilitation. Discuss pregnancy and hormonal treatment carefully. Seek emergency care immediately for recurrent chest pain, as SCAD can recur.
Questions to Ask Your Doctor
- Is my heart attack caused by SCAD?
- Do I need a stent or only medicines?
- Should I be screened for fibromuscular dysplasia?
- Is future pregnancy safe for me?
Common Mistakes to Avoid
- Ignoring chest pain because you are young and healthy.
- Doing intense exercise right after a heart attack.
- Stopping medicines early.
Booking, Timing and Report
Book a morning slot if possible, since fasting is easier. Carry your doctor's prescription, previous heart and blood reports, a recent creatinine report and a medicine list. Allow 45 to 90 minutes at the centre. Reports are usually ready within 24 to 48 hours, because vessel images need careful review.
Key Facts at a Glance
- SCAD is a tear in a heart artery wall
- It often affects younger women
- Most heal with medicines
- Chest pain always needs emergency care
Frequently Asked Questions
What is SCAD?
A spontaneous tear inside a heart artery.
Who gets SCAD?
Often younger women with few risk factors.
Is it caused by cholesterol?
Usually not.
Can CT angiography show SCAD?
In selected cases and for follow-up.
Does it need a stent?
Often not.
Can it come back?
Yes, in some people.
Is pregnancy risky after SCAD?
It needs specialist advice.
Should I exercise?
Gentle, supervised exercise is advised.
When is the report ready?
Usually 24 to 48 hours.
Book Your Test at Ganesh Diagnostic
Ganesh Diagnostic & Imaging Centre in Rohini, Delhi offers this test with trained radiology staff and clear reports. You can book an appointment online, check our branches across Delhi NCR, contact us for current rates, or explore all our services. Reports can be downloaded online through our patient portal, so you do not need to make a second trip just to collect them.
This article is for general information only. It does not replace advice from your doctor. Always follow your doctor's instructions for your test.
