What is SCAD?

‍Spontaneous Coronary Artery Dissection, or SCAD, happens when a tear develops in the inner layer of a coronary artery — the vessels that supply blood to your heart. As the tear forms, blood can collect between the layers of the artery wall, which can slow or block blood flow to the heart. This is different from the gradual plaque build-up behind most heart attacks, which is part of why SCAD can catch people, and sometimes their doctors, by surprise.‍ ‍

SCAD overwhelmingly affects women, most commonly in their 40s and 50s, though it can occur at any age and in men too. What makes it especially distinctive is that many people affected don't have the traditional risk factors usually associated with heart disease — no high cholesterol, no smoking history, no long-standing high blood pressure. Because of this, SCAD is sometimes mistaken for a typical heart attack, and awareness of it is still catching up with how common it actually is.

What increases the likelihood of SCAD?

‍ The exact cause of SCAD isn't yet fully understood, but a number of factors have been associated with it, including:

• Conditions affecting the blood vessels, such as fibromuscular dysplasia

• Pregnancy and the postpartum period

• Significant emotional or physical stress

• Inflammatory conditions, such as rheumatoid arthritis or lupus

• Hormonal therapies

• Connective tissue disorders, such as Marfan syndrome

‍Having one of these associations doesn't mean SCAD will happen — they're simply patterns researchers have observed, and the condition can also occur with none of them present at all.

Signs and symptoms

‍SCAD symptoms closely mirror those of a typical heart attack, and they require the same urgency: ‍

• Chest pain or pressure

• Pain in the arm, jaw or shoulder

• Shortness of breath

• Sweating

• A rapid or fluttery heartbeat

• Nausea or dizziness

• Extreme fatigue

‍If you or someone else experiences these symptoms, call 000 immediately. It isn't possible to tell SCAD apart from a typical heart attack without proper testing in hospital. ‍ ‍

Treatment and recovery

Treatment for SCAD depends on individual factors, including the size and location of the tear. Many cases are managed with medication alone and heal on their own over time. In some situations, a stent or bypass surgery may be needed, particularly if blood flow remains restricted or symptoms continue.

Recovery from SCAD is genuinely individual, and your cardiologist is best placed to talk you through what it looks like for you specifically. What we do know is that many people go on to recover well, and that structured, appropriately guided rehabilitation plays a meaningful role in that recovery — including a thoughtful, individualised return to movement once you've been medically cleared.

How exercise physiology supports SCAD recovery

Returning to exercise after SCAD understandably comes with more questions than after a typical cardiac event, partly because SCAD is less well known and partly because each case is genuinely different. Our approach includes:‍ ‍

• Individualised exercise planning that respects your specific SCAD history, treatment and medical guidance

• A gradual, carefully staged return to movement, building confidence alongside fitness

• Close attention to any individual precautions your cardiologist has identified for you

• Ongoing review and adjustment as your recovery and confidence progress

• A collaborative approach with your cardiology team, so your exercise plan aligns with your broader care

We offer this support through 1:1 Exercise Physiology — in person at Bondi Junction, Sydney, or via telehealth wherever you are in Australia.