SCAD Explained: The Pregnancy-Related Heart Attack Many People Don’t Know About

Most people think heart attacks are caused by cholesterol blockages.

That is true in many cases.

But in young women — especially during pregnancy or postpartum — a different and less known condition can cause a heart attack.

It is called Spontaneous Coronary Artery Dissection (SCAD).

SCAD is uncommon, but when it occurs, early recognition is critical.

What Is SCAD?

SCAD stands for Spontaneous Coronary Artery Dissection. (It is Pregnancy Relate Heart attack)

It occurs when a tear develops in the wall of a coronary artery.

Instead of plaque blocking the artery, what happens is:

• The artery wall splits

• Blood collects inside the wall

• A false channel forms

• The true blood flow pathway gets compressed

• This reduces blood flow to the heart muscle.

The result can be:

• Chest pain

• Heart attack

• Dangerous rhythm disturbances

How Is SCAD Different From a Typical Heart Attack?

Typical heart attack:

• Caused by cholesterol plaque rupture

• Common in older individuals

• Associated with diabetes, BP, smoking

SCAD:

• Often affects younger women

• May occur during pregnancy or postpartum

• Can occur without traditional risk factors

• Not caused by plaque buildup

This difference is important because management strategy may vary.

Who Is at Risk for SCAD?

SCAD is most commonly seen in:

• Women under 50

• During pregnancy

• Within weeks to months postpartum

• Individuals with fibromuscular dysplasia

• Those with connective tissue disorders

• Individuals under extreme emotional stress

It can also occur without any clear trigger.

Why Can SCAD Be Missed?

This is important.

Because many SCAD patients:

• Are young

• Appear healthy

• Have no major risk factors

• May have normal cholesterol

Initial symptoms may be mistaken for:

• Anxiety

• Gastric discomfort

• Musculoskeletal pain

Standard ECG and blood tests may show signs of heart injury, but the cause may not be obvious without detailed imaging.

Coronary angiography is usually required for diagnosis.

In some cases, specialized imaging such as OCT or IVUS may be needed.

Common Symptoms of SCAD

Symptoms can resemble a typical heart attack:

• Chest pain or pressure

• Shortness of breath

• Nausea

• Sweating

• Jaw or arm discomfort

• Dizziness

Because patients are often young, delays in diagnosis are common.

Delay increases risk.

Is SCAD Life-Threatening?

Yes, it can be.

But early recognition improves outcomes significantly.

Unlike plaque-related heart attacks, many SCAD cases are managed conservatively (without stenting), because:

• The artery may heal naturally

• Intervention can sometimes worsen the tear

Management depends on:

• Severity

• Blood flow compromise

• Hemodynamic stability

SCAD During Pregnancy: Why Awareness Is Critical

Pregnancy causes:

• Hormonal changes

• Increased blood volume

• Increased vessel wall stress

  Postpartum period is particularly high-risk.

These changes may predispose certain individuals to arterial wall weakness.

Any pregnant or recently postpartum woman experiencing chest pain should not ignore it.

Recovery and Long-Term Outlook

Many patients recover well with:

• Medical management

• Blood pressure control

• Cardiac rehabilitation

• Stress management

• Follow-up imaging

However, recurrence is possible.

Long-term monitoring is important.

When Should You Seek Immediate Care?

Do not ignore:

• Sudden chest pain

• Breathlessness

• Dizziness

• Fainting

• Persistent pressure sensation

Especially if you are:

• Pregnant

• Recently delivered

• Under significant stress

• Early evaluation saves heart muscle.

Final Takeaway

Not every heart attack is caused by cholesterol.

SCAD is a rare but serious condition that can affect young, otherwise healthy women.

Awareness prevents delay.

Early suspicion improves survival.

Timely imaging confirms diagnosis.

If you or someone you know experiences unexplained chest pain — especially during pregnancy or postpartum — seek immediate medical attention.

Medical Disclaimer

This content is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. If you experience chest pain, breathlessness, or concerning symptoms, seek emergency medical care immediately.