So, as the name suggests, SCAD (Spontaneous coronary artery dissection) is spontaneous. It happens suddenly, so if we are talking about whether it shows up on ECG, then yes, only if you happen to do the ECG at the moment of symptom.
Spontaneous Coronary Artery Dissection depends on when or where it occurs. If it occurs in a certain territory in the heart that the ECG can reflect on, then it can show up as an ECG sign. Because it is acute, it's almost like an acute heart attack because the dissection can potentially occlude the artery, but otherwise, it can't be seen.
You can go for a CT scan. I mean I would rather do what we call a coronary angiogram, but again, for such patients, they usually present as chest pain before going to various departments for checks. Or when the chest pain has gone off then you go and see an outpatient clinic. By then, there may not be any signs on the ECG because the pain has resolved, so these patients are what we call self-selective. So, they show up at a&e with ongoing symptoms or the symptoms have resolved well enough for them to see a specialist at an outpatient clinic.
So, it's a diagnosis that can only be made by a specialist, it's not something made using routine chest x-ray or ECG in patients that are symptoms free.
One more thing, the Spontaneous Coronary Artery Dissection usually typically occurs in females in the younger age group. That does not mean men can't get it but women get it more.
