Spontaneous coronary artery dissection - why does it happen?

Spontaneous Coronary Artery Dissection (SCAD) represents a non-atherosclerotic cause of acute coronary syndromes, primarily affecting women without traditional cardiovascular risk factors. Dr. David Adlam, from the University of Leicester, explains that the condition stems from an intramural hematoma within the coronary artery wall, which compresses the true lumen and restricts blood flow. Unlike atherosclerotic disease, SCAD often heals spontaneously over several weeks or months, making conservative management the preferred approach to avoid the high risks associated with stenting these fragile vessels. Diagnosis relies on coronary angiography, though clinicians must maintain a high index of suspicion due to frequent initial misdiagnoses. Because SCAD is often linked to a generalized arteriopathy, patients require comprehensive screening of their peripheral vasculature, while the routine use of aggressive post-infarction medical therapies warrants careful, individualized reconsideration.