Diagnosis

Tests used to diagnose SCAD are similar to those used to evaluate other types of heart attacks.

Tests may include:

Coronary angiogram

During a coronary angiogram, doctors inject a special dye into your arteries so they'll show up on imaging tests. To get the dye into your arteries, doctors insert a long, thin tube (catheter) into an artery — usually in your leg or arm — and thread the tube to the arteries in your heart.

Once the dye is released, doctors use X-rays to create pictures of the arteries. The X-rays may show abnormalities in an artery that help confirm SCAD. A coronary angiogram can also show if the arteries in the heart (coronary arteries) are abnormal and twisted (tortuous arteries).

Intravascular ultrasound

During heart catheterization, a special imaging catheter may be passed into your arteries to create pictures using sound waves (ultrasound). This may be conducted in addition to coronary angiography to help doctors confirm SCAD and plan treatment.

Optical coherence tomography

A catheter equipped with a special light may be passed into your arteries to create light-based pictures. Doctors may perform this test after coronary angiography.

The images may show abnormalities in an artery that can help doctors confirm the diagnosis and gather information to guide treatment.

Cardiac computerized tomography (CT) angiography

During cardiac computerized tomography (CT) angiography, you lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest, which can show abnormalities in your arteries.

Cardiac CT angiography may be used in addition to other tests or as a follow-up test to evaluate your condition after SCAD.