How To Prevent SCAD Heart Attack

SCAD stands for spontaneous coronary artery dissection. It happens when the layers of a coronary artery wall separate, often because bleeding develops within the artery wall. This can narrow or block blood flow to the heart muscle and cause a heart attack, even though the underlying cause is different from the plaque buildup behind most heart attacks.

Because SCAD doesn’t follow the same pattern as a typical plaque-related heart attack, prevention is different too. Some cases can’t be predicted or prevented, and researchers still don’t fully understand why SCAD happens in certain people. This guide covers what is known, which steps may help lower recurrence risk, and why working with a cardiologist or SCAD-experienced specialist matters, especially after a previous SCAD event.

This content is for informational purposes only and is not a substitute for medical advice. Never start, stop, or change a beta blocker, aspirin, blood pressure medication, or any other treatment based on this article without speaking to your doctor first.

Can SCAD Be Prevented?

There is currently no known way to guarantee that SCAD will never happen. This differs from typical heart attack prevention, where managing cholesterol, blood pressure, diabetes, and other established risk factors can lower risk. SCAD often affects people who don’t have the traditional risk factors usually associated with plaque-related heart attacks.

Researchers have identified several conditions and possible triggers associated with SCAD, including:

• Fibromuscular dysplasia, a condition involving abnormal cell growth within the walls of certain arteries
• Certain inherited connective tissue disorders
• Hormonal and reproductive factors, although their exact role isn’t fully understood
• Pregnancy and the postpartum period
• Extreme physical exertion or intense emotional stress in some cases
• Genetic susceptibility, including variations near the PHACTR1 and EDN1 genes

None of these factors explains every case, and having one doesn’t mean SCAD will happen. It also helps to separate two different goals. Very little is known about preventing a first SCAD event, while more guidance is available for lowering recurrence risk after an initial event. Managing your overall cardiovascular health remains worthwhile, but it can’t guarantee SCAD prevention.

Lifestyle Changes That May Help Prevent SCAD or Recurrence

Exercise Regularly

Regular, moderate physical activity supports cardiovascular health. After a SCAD event, many people can return to exercise, but the timing and intensity should be set with their care team.

Walking is often a practical, low-risk place to begin. Cardiac rehabilitation can provide supervised exercise and help you gradually rebuild strength and confidence. Sudden, strenuous activity is generally discouraged during recovery unless your cardiology team has cleared it. Our exercise and heart health guide covers general exercise principles, but anyone recovering from SCAD should follow guidance based on their own medical history.

Avoid Intense Weightlifting and Competitive Sports

Some people who have experienced SCAD are advised to modify or avoid high-intensity exercise, particularly heavy weightlifting, extreme endurance training, and competitive sports involving intense exertion. This doesn’t mean all exercise is unsafe.

Extreme or unusual physical exertion has been reported before some SCAD events, although that doesn’t establish it as a direct cause. Your cardiologist can help determine which activities and intensity levels are appropriate for you.

Manage Stress

Intense emotional or physical stress has been reported before some SCAD events. However, this doesn’t mean stress alone causes SCAD or that someone is responsible for their own event. Stress may act as a trigger in a person who already has an underlying vulnerability in the artery wall.

Helpful stress management approaches include:

• Relaxation exercises
• Mindfulness or meditation
• Getting adequate, consistent sleep
• Counseling or psychological support, which can be especially valuable given how common anxiety and distress are after a SCAD diagnosis

Our stress and heart health guide offers general strategies. A mental health professional familiar with serious medical events may also help with the emotional effects of a SCAD diagnosis.

Don’t Smoke or Vape

Smoking raises overall cardiovascular risk and is worth avoiding regardless of the type of heart event you’re trying to prevent. Smoking isn’t considered a main cause of SCAD, but quitting tobacco and avoiding vaping and secondhand smoke can still support cardiovascular health. Our guide on smoking and heart risk explains this connection further.

Follow a Heart Healthy Diet

A diet built around vegetables, fruits, whole grains, legumes, fish, healthy protein sources, and unsaturated fats supports general cardiovascular health. It also helps to limit highly processed foods, excess sodium, and saturated fat. Our anti inflammatory nutrition guide covers practical ways to build meals around these principles.

Maintain a Healthy Weight

Maintaining a healthy body weight through sustainable eating and appropriate physical activity supports overall cardiovascular health. Extreme dieting is not recommended, particularly during SCAD recovery, when your body needs consistent, balanced nutrition to heal.

Manage Blood Pressure, Cholesterol and Blood Sugar

Even though SCAD often occurs in people without traditional cardiovascular risk factors, managing blood pressure, cholesterol, and blood sugar remains an important part of cardiovascular health. This includes:

• Regular blood pressure monitoring
• Ongoing cholesterol management when medically indicated
• Blood sugar monitoring, particularly if insulin resistance or metabolic syndrome is present
• Regular medical checkups
• Taking prescribed medications exactly as directed

Traditional cardiovascular risk factors don’t necessarily explain why SCAD happens. Many people with SCAD don’t have high cholesterol or diabetes. Managing these factors supports overall cardiovascular health, but it shouldn’t be presented as a guaranteed way to prevent SCAD.

Can Stress Cause SCAD?

Some studies have found that emotional or physical stress occurred shortly before a SCAD event in a substantial portion of patients. Reported triggers have included grief, major life changes, intense exertion, straining, and childbirth.

This association doesn’t mean stress alone causes SCAD. Stress may act as a trigger when an underlying vulnerability is already present in the artery wall. And many people experience SCAD without an obvious trigger.

Relaxation techniques, adequate sleep, counseling, and emotional support may be useful parts of ongoing care. This can be especially important for SCAD survivors dealing with anxiety or fear of recurrence.

Exercise After SCAD

Most people can begin some form of physical activity after SCAD, although the timeline and intensity depend on their recovery. Your cardiology team should help decide when and how you return to exercise.

Cardiac rehabilitation can provide supervised exercise, education, and emotional support. Programs may be adjusted for SCAD because the recovery process differs from that of a plaque-related heart attack. Activity often begins with walking and gentle aerobic movement, then increases as your care team allows. Heavy lifting, extreme endurance activity, and competitive sports involving intense exertion may be restricted based on your condition and recovery.

Any exercise plan after SCAD should come from a healthcare professional familiar with your history rather than from general exercise guidelines.

Can Medications Prevent SCAD From Happening Again?

Medication decisions after SCAD depend on the person’s artery findings, treatment, medical history, blood pressure, and other risk factors. Medications that may be discussed include:

• Beta blockers, which have been associated with a lower recurrence rate in observational research and may be prescribed when tolerated
• Aspirin or other antiplatelet medications, depending on how the SCAD was treated, whether a stent was placed, and the person’s bleeding risk
• Blood pressure medications, when appropriate for your situation
• Cholesterol-lowering medications when there is another medical reason to use them, since statins aren’t automatically recommended for every SCAD patient

No medication can guarantee that another SCAD event won’t happen. Never start, stop, or change any of these medications without speaking with your cardiologist.

The Role of Cardiac Rehabilitation After SCAD

Cardiac rehabilitation is a supervised program that supports recovery after a serious cardiovascular event. For people recovering from SCAD, it may include:

• Exercise that gradually increases based on your recovery
• Education about SCAD, cardiovascular health, and appropriate activity levels
• Emotional support for anxiety, distress, or fear of another event
• Help rebuilding confidence in physical activity

A rehabilitation program may need to be adjusted for SCAD because the underlying condition and activity recommendations differ from those for a typical plaque-related heart attack. Tell your rehabilitation team that SCAD caused your heart attack so they can account for it when developing your program.

Conditions and Factors Associated With SCAD

Doctors may evaluate people with SCAD for several associated conditions and factors, including:

• Fibromuscular dysplasia
• Connective tissue disorders, such as Ehlers-Danlos syndrome or Marfan syndrome
• Hormonal factors
• Pregnancy or postpartum status
• Extreme physical or emotional stress
• Other vascular conditions

Having one or more of these factors doesn’t mean it directly caused your SCAD event. SCAD is thought to involve a combination of underlying artery vulnerability and possible triggers rather than one single cause.

How to Reduce the Risk of Another SCAD

For people who have already experienced SCAD, an individualized approach may include:

• Attending all recommended cardiology follow-up appointments
• Following your prescribed medication plan exactly as directed
• Participating in cardiac rehabilitation when recommended
• Exercising according to the plan provided by your care team
• Avoiding smoking and vaping
• Managing blood pressure
• Eating a heart healthy diet
• Maintaining a healthy weight
• Managing stress through sustainable, supported strategies
• Being evaluated for associated vascular or connective tissue conditions when recommended

Another SCAD event is possible even when you follow your treatment plan. Reported recurrence rates vary based on the study and how long patients were followed. Some research has found relatively low recurrence over the first few years, while longer studies have reported rates of 10% or more. Regular follow-up care remains important, but no single percentage can predict what will happen to an individual patient.

When to Seek Emergency Help

New or unexplained symptoms shouldn’t be dismissed, especially if you have a history of SCAD. Call emergency medical services for:

• Chest pain or pressure
• Shortness of breath
• Sweating
• Nausea
• Pain spreading to the arm, back, neck, or jaw
• Sudden weakness or other unusual symptoms

If you’ve had SCAD before, don’t assume new chest symptoms are anxiety or a normal part of recovery. Call emergency services and get evaluated. Our full warning signs guide covers general heart attack symptoms in more detail.

Frequently Asked Questions

Can SCAD be prevented? 

There is currently no known way to guarantee SCAD prevention because its causes aren’t fully understood. Managing your overall cardiovascular health and associated medical conditions may help, but it can’t guarantee that SCAD won’t occur.

How can I reduce my risk of SCAD recurrence? 

Follow your prescribed medication plan, attend cardiac rehabilitation when recommended, manage blood pressure, avoid intense exertion when advised, and keep up with regular cardiology follow-up care.

Can stress trigger SCAD? 

Emotional or physical stress has been reported before some SCAD events. Stress may act as one possible trigger in someone with an underlying artery vulnerability, but it isn’t considered the sole cause.

Does exercise increase the risk of SCAD? 

Moderate exercise that follows your care team’s guidance is generally considered beneficial. Sudden or extreme exertion has been reported before some SCAD events, but that doesn’t mean regular exercise causes SCAD.

Can weightlifting cause SCAD? 

Heavy weightlifting and intense straining have been reported as possible triggers before some SCAD events. Many people recovering from SCAD are advised to avoid or modify heavy lifting, but personal restrictions should come from their cardiology team.

What exercises are safe after SCAD? 

This varies by individual and should be determined by your cardiology team, though walking and gentle aerobic activity are common, cautious starting points during recovery.

Can diet prevent SCAD? 

A heart healthy diet supports overall cardiovascular health, but no specific diet has been shown to prevent SCAD directly.

Can high blood pressure cause SCAD? 

High blood pressure may place added strain on artery walls and has been associated with a higher risk of SCAD recurrence. However, it doesn’t explain every SCAD event, and many people who experience SCAD don’t have hypertension.

Can smoking increase the risk of SCAD?

Smoking isn’t considered a main cause of SCAD, but it raises overall cardiovascular risk and should be avoided.

Can statins prevent SCAD? 

Statins aren’t routinely prescribed solely because someone has experienced SCAD. They may still be appropriate for high cholesterol, plaque-related disease, diabetes, or another medical reason.

Do beta blockers prevent another SCAD? 

Observational research has linked beta blocker use with a lower recurrence rate after SCAD. However, beta blockers can’t guarantee prevention and may not be appropriate for everyone.

Should people with SCAD take aspirin? 

Aspirin recommendations vary after SCAD. The decision may depend on whether a stent was placed, how the SCAD was treated, and the person’s bleeding risk. Don’t begin or stop aspirin without speaking with your cardiologist.

What is life like after a SCAD heart attack? 

Many people return to active and fulfilling lives after SCAD. Recovery can still involve medication, follow-up care, changes to physical activity, and emotional support. The timeline is different for each person.

How rare is SCAD? 

SCAD is uncommon in the general population, but it is an important cause of heart attacks in younger and middle-aged women. It is also one of the leading causes of heart attacks associated with pregnancy and the postpartum period.

Is SCAD a heart attack?

SCAD is a condition that can reduce or block blood flow through a coronary artery. When that loss of blood flow damages the heart muscle, SCAD causes a heart attack. The mechanism differs from a typical plaque-related heart attack.

Can SCAD happen again? 

Yes. SCAD can happen again, but reported recurrence rates vary depending on the study and length of follow-up. Your cardiologist can discuss what is known about your personal risk.

What should I avoid after SCAD? 

You may be advised to avoid heavy weightlifting, extreme endurance activity, intense competitive sports, and smoking. Your cardiology team should provide restrictions based on your artery findings, recovery, and overall health.