Spontaneous Coronary Artery Dissection: A Growing Awareness of Heart Attacks in Younger Women

A heart attack is often associated with older individuals or those with pre-existing cardiovascular conditions. However, a specific type of heart attack, known as spontaneous coronary artery dissection (SCAD), is increasingly recognized as a cause of heart attacks in younger women, often those previously considered healthy. Diagnosis can be challenging, as symptoms may differ from traditional heart attack presentations.

Understanding Spontaneous Coronary Artery Dissection (SCAD)

SCAD occurs when a tear develops in the wall of a coronary artery. Blood collects within the artery wall, creating a hematoma that can reduce or block blood flow to the heart, leading to a myocardial infarction (heart attack). Unlike typical heart attacks caused by plaque buildup, SCAD is not usually linked to atherosclerosis.

Recent Research and Treatment Recommendations

A research team from Niš University Hospital in Serbia followed 123 patients with SCAD over four years and developed new treatment recommendations. The study, published in 2026, highlighted that SCAD is becoming more recognized, but remains underdiagnosed and understudied. Professor Svetlana Apostolović, the study leader, noted the limited number of randomized trials to determine the most appropriate treatment for SCAD. [1]

Key Findings from the Serbian Study

• High Healing Rate: Complete healing was achieved in 62.2% of the young women studied.
• Triggers: Psychological and physical stress were identified as common triggering factors.
• Hormonal Factors: SCAD occurred most frequently in non-pregnant young women and menopausal women.
• Stenting Not Always Beneficial: Stenting was not found to be beneficial for the majority of patients.
• Average Age: The average age of the women in the study was 47.5 years.
• Pregnancy and Recent Childbirth: 6.7% of patients were pregnant or had recently given birth.
• Menopause: 36.2% of patients were menopausal.

Current Treatment and Aftercare

Careful observation, along with antihypertensive medication, cardiac rehabilitation and psychological support, can improve long-term outcomes and reduce the impact of SCAD on daily life. [1] While treatment approaches are still evolving due to the limited research, a multidisciplinary heart team approach is crucial for complex coronary artery disease. [1]

The Importance of Awareness

SCAD often presents differently than traditional heart attacks, making early diagnosis challenging. Increased awareness among both healthcare professionals and the public is vital for improving outcomes for women experiencing this condition. The American Heart Association’s Go Red for Women movement highlights the importance of recognizing heart disease and stroke symptoms in women. [2]

Looking Ahead

Further research is needed to better understand the causes, optimal treatment strategies, and long-term effects of SCAD. Continued investigation will help refine diagnostic approaches and improve the lives of women affected by this increasingly recognized form of heart attack.