Spontaneous coronary artery dissection (often called SCAD) is a rare but serious heart condition that isn’t fully understood and tends to occur without warning.
While SCAD is still being studied, experts have identified several factors that could increase your risk of developing it, including genetics. Some people with SCAD have gene variants linked to other inherited heart conditions, which can play a role in its development.
We’ll explore whether SCAD is genetic, the risk factors associated with it, and how genetic testing can reveal variants tied to heart conditions that could increase your chances of SCAD.
What is SCAD, and what are its common symptoms?
SCAD happens when a tear forms in one of the heart's arteries, which causes blood to get trapped in the artery wall, creating a blockage that slows down or stops blood flow to the heart. If not treated in time, it can lead to a heart attack.
In many cases, SCAD seems to happen out of the blue. It often affects people who appear healthy, and it’s most commonly seen in women under 50. Still, it’s important to know that SCAD can happen to anyone, regardless of age or gender.
Some of the most common symptoms people report during a SCAD event include:
Chest pain or pressure
Shortness of breath
A fast or fluttering heartbeat
Pain in the arms, back, jaw, or neck
Feeling lightheaded or faint
Sweating, nausea, or sudden fatigue
If you ever experience these symptoms, especially if they come on suddenly, get medical help quickly. It can make a huge difference and may prevent severe complications.
Is SCAD hereditary, and can genetics increase your risk of developing this condition?
SCAD itself isn’t classified as a hereditary disease as there’s not enough evidence to suggest that it can be passed down from parents to children. However, genetic factors can influence whether someone is at higher risk of developing the condition.
Based on genetic risk factors, SCAD is generally classified into two categories:
Syndromic SCAD, associated with certain inherited connective tissue disorders
Sporadic SCAD
The table below explains the differences between the two types:
Parameter | Syndromic SCAD | Sporadic SCAD |
Genetic link | Associated with known genetic disorders like Marfan syndrome | No clear genetic cause has been identified |
Prevalence | Less common, typically occurring in 5–13% of SCAD cases | The most common form, occurring in over 80% of SCAD patients |
Although most SCAD cases tend to be spontaneous, a small percentage have been found to occur in people who already have a preexisting heart condition. That’s why genetic tests, such as those offered by Nucleus, could be a smart first step, helping you identify genes linked to conditions that can increase your risk of developing SCAD.
What are the genetic conditions linked to SCAD?
Source: Pavel Danilyuk
Research shows that some people who experience SCAD also have specific underlying genetic conditions, which often make the blood vessels more fragile. However, there is no single “SCAD gene” that has been directly linked to the condition.
Most of these genetic factors that can increase your risk of developing SCAD fall into two main groups:
Connective tissue disorders
Genetic conditions that affect the arteries
We’ll explain each in detail below.
1. Connective tissue disorders
Connective tissue disorders (CTDs) affect the tissues supporting various body parts, including your heart’s arteries. They can make your arteries more fragile, resulting in SCAD. Some of the CTDs that are often associated with SCAD include:
Vascular Ehlers-Danlos syndrome (vEDS): A rare disorder that weakens blood vessel walls and makes them more prone to dissection or rupture.
Marfan syndrome: A genetic disorder that weakens connective tissue and causes your arteries to become enlarged or fragile.
Loeys-Dietz syndrome: A condition that makes your arteries fragile and twisted, increasing the risk of spontaneous dissections like SCAD.
So, what causes these disorders in the first place?
It usually comes down to your genes. We all have certain genes responsible for keeping our connective tissues strong and stretchy. Specific gene variants (changes in the genes) can prevent these tissues from functioning properly, making your artery walls weaker.
The table below outlines the genes linked to these connective tissue disorders:
Connective tissue disorder | Association genes |
vEDS | COL3A1 |
Marfan syndrome | FBN1 |
Loeys-Dietz syndrome | TGFBR1, TGFBR2 |
Among these, studies have frequently linked vEDS to SCAD. Still, these genetic conditions are rare, and most SCAD cases occur without a known underlying connective tissue disorder.
2. Genetic conditions that affect the arteries
Some genetic conditions, known as genetic aortopathies or arterial disorders, target your arteries directly. They make your blood vessels more fragile or more likely to stretch, bulge, or tear. If the walls of your coronary arteries are weakened, it raises your chances of developing SCAD.
An example of a condition like this is familial thoracic aortic aneurysm/dissection (FTAAD), associated with changes in genes ACTA2 and MYH11. This disorder makes the walls of major arteries more likely to rupture.
Other risk factors associated with SCAD
Source: Andrea Piacquadio
Although SCAD often occurs without prior signs, doctors and researchers have identified some common patterns among people who’ve had the condition. These patterns point to several risk factors, including:
Hormonal factors
Emotional and physical stress
Vascular abnormalities
Autoimmune and inflammatory conditions
High blood pressure and certain drug use
Let’s examine how each of these factors connect to SCAD.
1. Hormonal factors
Hormonal changes, especially involving female sex hormones, are one of the crucial non-genetic risk factors linked to SCAD. Since the majority of SCAD patients are women, often under 50, researchers believe that estrogen and other hormones may play a role in weakening artery walls or increasing the risk of dissection.
Some hormone-related triggers that may increase SCAD risk include:
Pregnancy
The postpartum period (especially within the first few weeks after delivery)
Fertility treatments
Some evidence to suggest hormonal birth control (oral contraceptives)
One SCAD patient shared that after her diagnosis, her doctor explained that oral contraceptives could have been a trigger for her SCAD event. While more research is needed, it appears that hormones can influence how vulnerable your arteries are.
Bonus: Learn other risk factors that can increase a woman’s chances of developing heart disease.
2. Emotional and physical stress
Stress (both emotional and physical) is another factor that’s been linked to SCAD. Some people who’ve had SCAD describe going through a period of intense stress just before it happened.
This can include intense physical activities like heavy lifting or distressing situations like grief, breakups, or intense pressure at work.
One SCAD survivor even stated that after her episode, her doctor advised her to avoid heavy lifting because it could increase her risk of having another SCAD event.
3. Vascular abnormalities
One vascular condition strongly linked to SCAD is fibromuscular dysplasia (FMD). FMD causes abnormal cell growth in the walls of arteries, which can cause them to twist, narrow, or even bulge.
When arteries are already fragile or irregular due to FMD, they’re more prone to tearing, and that’s exactly what happens during SCAD. This condition is more prevalent in women and is often linked to hormonal fluctuations.
4. Autoimmune and inflammatory conditions
Autoimmune and inflammatory conditions have also been linked to SCAD. These diseases cause the body’s immune system to mistakenly attack its own tissues, including blood vessels. Conditions like lupus or sarcoidosis can cause inflammation in the arteries, making them more fragile or swollen. When inflamed or damaged, blood vessels are more susceptible to tearing.
5. High blood pressure and certain drug use
When your blood pressure is extremely high, the force of blood flowing through your arteries can cause stress on the vessel walls. Over time, this pressure can weaken the walls or even cause a spontaneous tear.
In addition, drugs like cocaine and methamphetamines are known to raise heart rate and blood pressure rapidly. This sudden surge in pressure can lead to a tear in the artery wall, especially if it is already vulnerable.
SCAD genetic testing: A step towards proactive heart health
While SCAD isn’t fully understood and risk factors are still being studied, being aware of the potential causes can make a real difference. Risk factors don’t imply that you’ll definitely develop SCAD, but knowing them allows you to take preventive measures for your health.
For those with potential risk, genetic testing is one of the most empowering tools available. It can help uncover whether you carry genetic variations linked to conditions that increase SCAD risk, like Vascular Ehlers-Danlos syndrome, Marfan syndrome, or familial aortic diseases. These are serious, often hereditary conditions that can weaken arteries and make SCAD more likely.
Nucleus Health is one of the most comprehensive DNA testing options available if you want to screen for heart conditions, neurological health, metabolic conditions, and more. While other tests in the market analyze only specific sections of your DNA, Nucleus’ all-in-one health test will look at ~100% of your DNA to give you insights into the common and rare disease risks you might carry.
Nucleus Health: Genetic testing for cardiovascular risks
Nucleus Health can screen your risks for [NUM_CONDITIONS_SCREENED]+ conditions, including hypertension, coronary artery disease, and more, with 99.9% accuracy. Because this is a whole-genome sequencing analysis, you can also go through your raw DNA data to find 130+ gene variations linked to heart conditions like vEDS, Marfan syndrome, and familial thoracic aortic aneurysms.
What sets Nucleus apart?
You get nearly all of your genome sequenced, which means the test is more likely to find rare variants linked to heart diseases than a gene panel that only tests for a few conditions.
Your results are delivered in clear, illustrative reports that help you understand your genetic makeup.
Nucleus AI allows you to receive personalized health recommendations based on your results.
You can also access genetic counseling through Nucleus’ partner, SteadyMD, so you can ask questions for prevention and care.
The test is physician-ordered, meaning Nucleus handles the clinical side of requesting a test, and you don’t have to chase your doctor to order the test on your behalf.
With Nucleus, you also get insights on traits and conditions like alcohol dependency and celiac disease that can help you build a tailored health plan.
How to get started with Nucleus
Nucleus makes it easy with an at-home genetic test — no need for doctor’s appointments or blood draws. Just collect cheek swabs from the comfort of your home.
Here’s how it works:
Fill out the required information
Order your kit
The Nucleus test costs [PRICE.KIT_SOLO.ONE], which includes the test kit, shipping, whole genome sequencing, and detailed reports. When your kit arrives, collect your sample and send it back using the prepaid packaging. You’ll receive clear, personalized reports explaining your results and potential health risks within six to eight weeks.
Nucleus is HIPAA-compliant and provides absolute data privacy. Its partner clinics are CAP/CLIA-certified.
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Featured image source: Gustavo Fring
