Gender Differences in Presentation and Outcomes of Spontaneous Coronary Artery Dissection (SCAD): A Single Center Case Series Study

Background: Spontaneous Coronary Artery Dissection (SCAD) is an important non-atherosclerotic cause of acute coronary syndrome (ACS), predominantly affecting younger females. Despite increasing recognition, data on gender-based differences in SCAD presentation and outcomes remain limited, particularly in South Asian populations. Methods: This retrospective case series included 24 patients diagnosed with SCAD at Abbas Institute of Medical Sciences (AIMS) between January 2022 and March 2025. Patient demographics, clinical presentation, angiographic findings, management strategies, and outcomes were analyzed with a focus on gender-based differences. Results: Of the 24 patients, 17 were female (70.8%) and 7 were male (29.2%). Females were younger and had fewer traditional cardiovascular risk factors. Chest pain was the most common symptom (91.7%), and NSTEMI was the predominant ACS type. Conservative management was favored in females, while PCI was significantly more common in males (71.4% vs 11.8%, p = 0.004). All patients survived the acute episode; two experienced recurrent SCAD. No 30-day mortality was observed. Conclusion: SCAD predominantly affects younger females with minimal risk factors and generally has favorable short-term outcomes. However, males may present with more severe forms requiring intervention. These gender differences highlight the need for individualized diagnostic and therapeutic approaches.