The SCAD medical abbreviation stands for spontaneous coronary artery dissection, a tear or bleed inside the wall of a heart artery that can block blood flow and cause a heart attack. Unlike the usual heart attack, it is not caused mainly by cholesterol plaque.
SCAD often affects people who seem at low risk, especially women in their 40s and 50s, and it is an important cause of heart attacks during pregnancy and soon after delivery. A separate, rare meaning appears on newborn screening reports: SCAD deficiency, an inherited metabolic condition. This guide explains both and shows how SCAD reads in a cardiology report.
At a glance
Stands for
Spontaneous coronary artery dissectionOther meanings
Short-chain acyl-CoA dehydrogenase deficiency (metabolic)Specialty
Cardiology, women's heart health, geneticsUsual diagnosis
Coronary angiography, written as LHC or cathLinked condition
Fibromuscular dysplasia, an artery wall disorderDo not confuse with
CAD, plaque-based artery disease
Breaking down the SCAD medical abbreviation
| Word | Meaning |
|---|---|
| Spontaneous | Happens without injury or a medical procedure causing it |
| Coronary | The arteries that wrap around and feed the heart muscle |
| Artery | A vessel carrying blood away from the heart |
| Dissection | The layers of the vessel wall separate |
In SCAD, either a small tear in the inner lining or bleeding inside the wall creates a false channel. Blood or a bruise-like collection, called an intramural hematoma, pushes inward and narrows the true channel. Less blood reaches the heart muscle beyond it.
Who is affected and how it presents
Most people with SCAD are women, many of them younger than the typical heart attack patient and without classic risk factors such as diabetes or high cholesterol. Associations noted in research include pregnancy and the months after delivery, fibromuscular dysplasia, intense physical exertion, severe emotional stress and some connective tissue disorders. Men can have SCAD too.
Symptoms are those of any heart attack: chest pain or pressure, discomfort spreading to an arm, the jaw or between the shoulder blades, breathlessness, a cold sweat, queasiness or feeling faint. It is often labeled as an ACS or MI first, with SCAD named once the arteries are imaged.
How SCAD appears in a cath report
Catheterization report: "LHC: smooth tapering narrowing of mid LAD consistent with SCAD with intramural hematoma, TIMI 3 flow. No atherosclerotic disease elsewhere. Recommend conservative management, no PCI." LAD is the left anterior descending artery, TIMI 3 means normal flow past the narrowing, and PCI means a stent procedure.
Notes may also describe the type of dissection seen on angiography and order a scan to look for fibromuscular dysplasia in other arteries. An echocardiogram, written TTE, checks how well the heart is pumping.
SCAD compared with a plaque heart attack
| Feature | SCAD | Plaque-related MI |
|---|---|---|
| Main cause | Tear or bleed in the artery wall | Cholesterol plaque rupture with a clot |
| Typical patient | Often a woman without usual risk factors | Older adults with risk factors |
| Common approach | Often conservative, as many dissections heal | Often a stent or bypass |
Stents can be harder to place in a fragile, torn artery, which is one reason teams frequently let it heal with medicines and monitoring when blood flow is adequate. Unstable cases may still need a stent or bypass.
The newborn screening meaning
On a newborn screening result or genetics note, SCAD may mean short-chain acyl-CoA dehydrogenase deficiency, sometimes written SCADD. It is an inherited condition affecting how the body breaks down certain fats for energy, and it is flagged by a raised level of a marker called C4 acylcarnitine. Many children identified this way have few or no symptoms, and specialists guide any follow-up.
If the report comes from a newborn screening lab or a metabolic clinic, this is the meaning, not a heart condition.
After SCAD: questions for the heart team
- Which artery was affected, and has the heart muscle been damaged?
- Should other arteries be checked for fibromuscular dysplasia?
- Is cardiac rehabilitation recommended, and what activity limits apply?
- What should future pregnancy planning involve?
More heart and vessel terms can be found in the diagnosis abbreviations collection.
This page covers the meaning of SCAD in general. Recovery plans, medicines and activity advice after a dissection should come from your cardiologist, who has seen your images and test results.
Frequently asked questions
What does SCAD stand for in cardiology?
SCAD stands for spontaneous coronary artery dissection. It is a tear or bleed in the wall of a heart artery that narrows or blocks it.
Is SCAD a heart attack?
SCAD is one cause of heart attack. The dissection reduces blood flow to the heart muscle, which can lead to an MI, though it happens differently from the usual plaque-related type.
Who is most likely to have SCAD?
It is most often seen in women, including younger women and those who are pregnant or recently gave birth. Many have few traditional heart risk factors.
Is SCAD the same as CAD?
No. CAD means coronary artery disease from plaque buildup. SCAD is a separation of the artery wall layers and usually occurs without major plaque.
What does SCAD mean on a newborn screen?
On a newborn screen, SCAD usually refers to short-chain acyl-CoA dehydrogenase deficiency, an inherited condition affecting fat metabolism. Specialists review the result and decide on follow-up.