Health condition
SCAD deep dive
Spontaneous coronary artery dissection (SCAD) is a tear within the wall of a heart artery causing a heart attack without atherosclerosis; it predominantly affects younger women and is managed differently from a typical heart attack.
Why trust this guide
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Editorial team
Written by our editorial team from the UK sources listed on each page.
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Sourced from guidance
Checked against current NHS and UK specialist society guidance at the time of review.
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Current for 2026
Reviewed on 2026-09-27 with the next review scheduled for 2027-09-27.
Key points
What matters most, at a glance.
The essentials in plain English - symptoms, when to seek help, who to see and what treatment looks like.
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Any acute chest pain is a 999 emergency - SCAD is diagnosed on angiography during heart attack care
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It accounts for a substantial share of heart attacks in women under 50 and around pregnancy
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Most SCAD heals on its own, so conservative management is usually preferred over stenting
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Associated conditions - fibromuscular dysplasia in particular - are screened for with head-to-pelvis imaging
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Recurrence risk is real; blood pressure control, tailored exercise advice and specialist follow-up reduce it
Understanding it
About SCAD deep dive, and what to do next.
In SCAD, blood tracks within the artery wall and compresses the true channel, starving heart muscle downstream. Because the artery wall is fragile, instrumenting it with wires and stents can extend the tear, which is why - counter to standard heart attack practice - most cases are treated with medication and monitored healing.
Aftercare is where specialist input tells: screening for fibromuscular dysplasia, advice on pregnancy and hormones, structured cardiac rehabilitation with modified lifting guidance, and peer support through charities such as Beat SCAD. Most people start with their GP, who can refer to a consultant cardiologist with expertise in SCAD. In many parts of the UK, routine NHS referrals for this kind of problem currently take 20-45+ weeks, whereas an initial private consultation is typically available within around two weeks.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, see them - and seek urgent care for any emergency symptoms described above.
Frequently asked
Common questions about SCAD deep dive.
Quick, plain-English answers to what people ask us most.
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What is spontaneous coronary artery dissection (SCAD)?
SCAD is a tear within the wall of a heart artery that causes a heart attack without the usual plaque build-up (atherosclerosis); it predominantly affects younger women, often without typical cardiovascular risk factors.
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What causes SCAD?
The exact cause isn't fully understood, but it's linked to hormonal factors, connective tissue abnormalities, extreme physical or emotional stress, and sometimes occurs around pregnancy or postpartum.
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What are the symptoms of SCAD?
Symptoms are similar to a typical heart attack - chest pain, breathlessness, and sometimes pain radiating to the arm or jaw - which is why it's diagnosed the same way, through emergency cardiac assessment.
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Is SCAD dangerous?
Yes, it is a heart attack and needs emergency treatment, though management can differ from typical heart attacks since the underlying mechanism and risk of certain interventions differ.
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How is SCAD treated?
Treatment often favours conservative medical management over stenting where possible, since the dissected artery can heal on its own, though the specific approach depends on severity and blood flow.
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Does SCAD recur?
Yes, there is a meaningful risk of recurrence, which is why ongoing cardiology follow-up and risk factor management, alongside screening for associated conditions like fibromuscular dysplasia, is important.
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SCAD vs a typical heart attack - what's the difference?
A typical heart attack results from atherosclerotic plaque rupture and blockage, whereas SCAD involves a spontaneous tear in the artery wall without significant plaque, occurring in a notably different patient group, often younger women.
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When should I seek emergency care for possible SCAD?
Call 999 immediately for chest pain or symptoms of a heart attack, regardless of age or risk factors - SCAD is diagnosed and initially managed the same way as any suspected heart attack.