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Background Spontaneous coronary artery dissection (SCAD) is a myocardial infarction mainly affecting women. It is thought to occur in the absence of cardiovascular risk factors. Traditional cardiac rehabilitation was not designed for SCAD and more tailored interventions may be beneficial.Aim To test a co-designed SCAD online recovery intervention.Methods The online intervention consisted of an initial consultation with a specialist nurse and five exercise counselling sessions over 8-weeks, supported by use of a wearable device. Participants were recruited from the waiting list of the Leicester Hospital SCAD clinic between October 2024 and January 2025. Participants completed questionnaires prior to the initial consultation, and pre and post-exercise counselling intervention (including demographics/health questions and the Warwick Edinburgh Mental Wellbeing Scale), and a remote 6-minute walk test pre and post-exercise counselling intervention. Descriptive analysis of demographic, health and attendance data, and pre and post-tests (Wilcoxon signed rank test and Friedman test with Bonferroni correction) were conducted using SPSSv29.Results Sixty-one patients were screened for eligibility and 51 information packs were posted to potential participants. Thirty-two patients consented, of whom two were ineligible to take part and two did not start. Twenty-eight participants started the study. The majority were female (n=27, 96.4%) and mean age was 55.0±8.2 years. Ten (35.7%) previously smoked, 14 (50.0%) were overweight/obese, 13 (46.4%) had a history of hypertension and 12 (42.9%) of hyperlipidaemia. Twenty-four participants (85.7%) completed the intervention. Median attendance at exercise counselling sessions was 5 (IQR 0). Post-exercise counselling intervention 6-minute walk distance (median=594m) was significantly greater than pre-exercise counselling intervention (median=499m), z = 3.41, p<.001. Mental wellbeing significantly increased during the intervention, χ 2 (2) = 13.899, p<.001, between baseline and post-intervention (p=0.008) and between pre- and post-exercise counselling intervention (p=0.004).Conclusion The high completion rate suggests the intervention is highly acceptable. Further testing is required.