Spontaneous Coronary Artery Dissection Clinic

The Spontaneous Coronary Artery Dissection (SCAD) Clinic at St. Michael’s Hospital provides care to patients who have been diagnosed with spontaneous coronary artery dissection. SCAD occurs when a tear forms in a coronary artery. The tear itself can cause symptoms of chest discomfort but can also interfere with blood flow resulting in a heart attack. 

Our clinic focuses on diagnosing SCAD and educating patients about the condition.  SCAD is becoming increasingly recognized as a cause of heart attack, particularly in young women. At St. Michael’s Hospital, we are heavily involved in researching the causes of this and are embarking on clinical trials evaluating the effects of treatment for this. 


Staff Interventional Cardiologist, St. Michael’s Hospital
Interventional Cardiology Fellowship Director, St. Michael’s Hospital
Medical Director, Complex PCI/CTO, St. Michael’s Hospital

Assistant Professor, University of Toronto

Dr. John J. Graham attained his Bachelor of Science in Neuroscience with first class honours in Neuroscience through University of Glasgow, before obtaining a Bachelor of Medicine and Bachelor of Surgery degrees (MBChB) with Commendation from the same institution. Dr. Graham has also completed a postgraduate medical diploma through the Royal Colleges of Physicians of the United Kingdom (MRCP).

Clinical interests and areas of expertise:complex coronary angioplasty and CTO PCI; SCAD/FMD; renal denervation for hypertension

Academic interests (research, teaching/education, quality improvement etc.):

Publications: Link

Department: Medicine

Division: Cardiology

Clinics: General Cardiology, Spontaneous Coronary Artery Dissection (SCAD/FMD), Complex coronary angioplasty and Chronic Total Occlusion (CTO)

Languages: English

Contact Information: 

Clinic (Ms. T. Plante) T: 416-864-5846 F: 416-864-5914

Fellowship administration (Ms. K. Giles) T: 416-864-6060 ext 3461; F: 416-864-5914

Location: St. Michael’s Hospital


St. Michael’s Hospital

30 Bond St.,
Toronto, ON
M5B 1W8
The main entrance is located near Queen St. East and Victoria St. The Bond St. entrance is not open to the public at this time.

Robert McRae Heart Health Unit
7th Floor Donnelly North


SCAD Clinic – Dr. John J. Graham
Clinical Assistant: Terri-Lynn Plante

Tel: 416-864-6060 Ext. 43844

Fax: 416-864-5914

Email: Terri-Lynn.Plante@unityhealth.to


Common risk factors for SCAD: 

  • Female (>90%)
  • Hormonal changes (Pregnancy, perimenopause, hormone therapy)
  • Fibromuscular Dysplasia
  • Stress (Emotional or Physical)
  • Inflammatory conditions
  • Genetic conditions

Possible further investigations

  • CT scans
      • Abdomen


  • Cardiac MRI
  • Echocardiogram
  • Coronary angiogram +/- angioplasty


Medicines – the majority of patients require some medications for at least a short period of time. These typically include:

  • Aspirin
  • Beta blockers
    • Angioplasty –  Rarely, patients require angioplasty and/or a stent
    • Cardiac surgery – Very, very rarely, bypass surgery is required

Health-care Providers

For all new referrals please send all relevant cardiac notes and test results including:

  • Discharge summary
  • Cath report
  • Echocardiogram
  • CT head/neck/abdomen if available
  • Angiogram images (CD or Pockethealth)

Referral form