Spontaneous Coronary Artery Dissection (SCAD) Explained

Esther Kim, MD, PhD

At the annual FMDSA Patient Meeting in Cleveland Ohio, we talked with Esther Kim, MD, MPH, of Vanderbilt University about SCAD (spontaneous coronary artery dissection).
SCAD stands for spontaneous coronary artery dissection. It is a rare condition that occurs when a tear forms in one of the blood vessels in the heart.
Dr. Kim noted that approximately 1% of heart attacks show signs of coronary artery dissection but it is likely under diagnosed. According to Dr. Kim, if we were to look closely a very specialized population, limited to women who are less than 50 years of age who present with heart attack, it is likely that about 1/4 to 1/3 of those patients will have heart attacks with SCAD.
Also, there is a relation between SCAD and FMD (fibromuscular dysplasia). Dr. Kim said that if you take a person who has coronary dissection and you do a CT scan from head to pelvis about 1/2 to 3/4 of the time you will find FMD. In contrast, data from the FMD registry indicates that about 3% of FMD patients will say they had a diagnosis of SCAD.  “There's certainly this mismatch going from one direction to the other but they are probably very intricately involved and SCAD it's probably just another manifestation of FMD in a patient,” said Dr. Kim.

For more information about SCAD and FMD, visit
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