How is it possible to have a heart attack without atherosclerosis or "plaque"? The answer is “spontaneous coronary artery dissection.” SCAD is a tear, or split, in the artery’s inner lining, which creates a blockage of blood clot or tissue. SCAD is an under-recognized cause of acute coronary syndrome, heart attack and sudden cardiac arrest. Learn more: www.scadalliance.org Stop SCAD -- Save a Heart.