Spontaneous coronary artery dissection causes

Spontaneous Coronary Artery Dissection Microchapters
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Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Spontaneous coronary artery dissection from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Approach
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Angiography
CT
MRI
Echocardiography
Other Imaging Findings
Other Diagnostic Studies
Treatment
Treatment Approach
Medical Therapy
Percutaneous Coronary Intervention
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Type 1 Case 1 Case 2 Case 3 Case 4 Case 5 Case 6 Case 7 Type 2A Case 1 Case 2 Case 3 Case 4 Case 5 Case 6 Type 2B Case 1 Case 2 Case 3 Case 4 Type 3 Case 1 Case 2 Case 3 Case 4 Case 5 Case 6

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A.

Synonyms and keywords: SCAD

Overview

Spontaneous coronary artery dissection may occur as a result of predisposing factors (e.g., vasculopathy, connective tissue disorder, systemic inflammation) compounded by precipitating stressors (strenuous exercise, emotional stress, medications).

Causes

The exact etiology of spontaneous coronary artery dissection (SCAD) remains elusive and appears to be multifactorial. It has been postulated that the phenotypic manifestation of SCAD may occur as a result of predisposing factors compounded by precipitating stressors. Conditions that have been implicated as a potential cause include:

Potential Cause	Condition
Predisposing factors	Fibromuscular dysplasia Takotsubo cardiomyopathy Pregnancy-related: antepartum, early post-partum, late post-partum, very late post-partum Recurrent pregnancies: multiparity or multigravida Connective tissue disorder: Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome type 4, cystic medial necrosis, alpha-1 antitrypsin deficiency, polycystic kidney disease Systemic inflammatory disease: systemic lupus erythematosus, Crohn's disease, ulcerative colitis, polyarteritis nodosa, sarcoidosis, Churg-Strauss syndrome, Wegener's granulomatosis, rheumatoid arthritis, Kawasaki disease, giant cell arteritis, celiac disease Hormonal therapy: oral contraceptive, estrogen, progesterone, beta-HCG, testosterone, corticosteroids Coronary artery spasm Idiopathic
Precipitating stressors	Intense exercises including isometric or aerobic activities Intense emotional stress Labor and delivery Valsava-type activities: retching, vomiting, bowel movement, coughing Recreational drugs: cocaine, amphetamines, methamphetamines Hormonal therapy: beta-HCG, corticosteroids