Spontaneous coronary artery dissection differential diagnosis: Difference between revisions
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| Pregnancy (peri-partum, history of multiple pregnancy)/ Female gender || +1 | | Pregnancy (peri-partum, history of multiple pregnancy)/ Female gender || +1 | ||
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| History of coronary artery spasm/ | | History of coronary artery spasm/ Previous SCAD || +3 | ||
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| Amphetamines/Cocaine/Vasospastic drug abuse || +1 | | Amphetamines/Cocaine/ Vasospastic drug abuse || +1 | ||
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| Systematic inflammation (SLE, Chron disease, sarcoidosis, polyarteritis nodosa, Behcet's syndrome || +2 | | Systematic inflammation (SLE, Chron disease, sarcoidosis, polyarteritis nodosa, Behcet's syndrome || +2 | ||
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| colspan="2" | In the presence of a score of at least three points in a patient presenting with chest pain, ECG/Echo abnormalities or troponin rise/fall, perform OCT/IVUS analysis for suspected SCAD. | | colspan="2" | In the presence of a score of at least three points in a patient presenting with chest pain, ECG/Echo abnormalities or troponin rise/fall, perform OCT/IVUS analysis for suspected SCAD. | ||
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==References== | ==References== | ||
Revision as of 22:59, 26 November 2017
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Spontaneous Coronary Artery Dissection Microchapters |
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Differentiating Spontaneous coronary artery dissection from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Type 1 Type 2A Type 2B Type 3 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arzu Kalayci, M.D. [2]
Synonyms and keywords: SCAD
Overview
Differential Diagnosis
While Type 1 SCAD has a pathognomonic appearance on angiography, Type 2 may be and Type 3 typically is indistinguishable from atherosclerosis. Risk factors and patient history may help determine diagnosis. Intracoronary imaging provides the most objective tool in differentiating between SCAD and atheroma.[1]
| Clinical-Angiographic Score System for SCAD Faster Diagnosis | |
|---|---|
| Clinical Characteristics | |
| Connective tissue disorder (Marfan syndrome, Ehler-Danlos syndrome, cystic medial necrosis) / Fibromuscular Dysplasia | +2 |
| Youth/<50 year | +1 |
| Estroprogestinic therapy | +1 |
| No classical coronary risk factors | +1 |
| Pregnancy (peri-partum, history of multiple pregnancy)/ Female gender | +1 |
| History of coronary artery spasm/ Previous SCAD | +3 |
| Amphetamines/Cocaine/ Vasospastic drug abuse | +1 |
| Systematic inflammation (SLE, Chron disease, sarcoidosis, polyarteritis nodosa, Behcet's syndrome | +2 |
| Emotional/ Physical stress | +1 |
| Angiographic Characteristics | |
| One vessel disease (no typical atherosclerotic lesions in order coronary arteries) | +1 |
| Long/tortuose suspected lesion | +1 |
| Diffuse, typically smooth arterial narrowing | +1 |
| At least 3 points: Indication to perform endovascular imaging (OCT or, if not available, IVUS) | |
| In the presence of a score of at least three points in a patient presenting with chest pain, ECG/Echo abnormalities or troponin rise/fall, perform OCT/IVUS analysis for suspected SCAD. | |
References
- ↑ Yip A, Saw J (2015). "Spontaneous coronary artery dissection-A review". Cardiovasc Diagn Ther. 5 (1): 37–48. doi:10.3978/j.issn.2223-3652.2015.01.08. PMC 4329168. PMID 25774346.