Spontaneous coronary artery dissection pathophysiology: Difference between revisions
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At present the pathophysiology of SCAD continues to be poorly understood due to the rarity of this condition and its heterogeneous pathology. In SCAD the affected [[coronary artery]] develops a tear, causing blood to flow between the coronary arterial layers eventually forcing them apart. The pattern of dissection in SCAD is different from the pattern observed in patients with pre-existing [[atherosclerosis]]. In SCAD the plane of dissection lies within the outer third of the [[tunica media]] or between the [[media]] and [[adventitia]]. Dissections can be present in either one artery or several arteries concomitantly.<ref name="pmid12403896">{{cite journal |author=Choi JW, Davidson CJ |title=Spontaneous multivessel coronary artery dissection in a long-distance runner successfully treated with oral antiplatelet therapy |journal=[[The Journal of Invasive Cardiology]] |volume=14 |issue=11 |pages=675–8 |year=2002 |month=November |pmid=12403896 |doi= |url=}}</ref> The dissecting plane between [[intima]] and [[media]] creates a false lumen and the resulting [[hematoma]] compresses the vessel lumen causing [[myocardial ischemia]] or [[myocardial infarction]] (MI). | At present the pathophysiology of SCAD continues to be poorly understood due to the rarity of this condition and its heterogeneous pathology. In SCAD the affected [[coronary artery]] develops a tear, causing blood to flow between the coronary arterial layers eventually forcing them apart. The pattern of dissection in SCAD is different from the pattern observed in patients with pre-existing [[atherosclerosis]]. In SCAD the plane of dissection lies within the outer third of the [[tunica media]] or between the [[media]] and [[adventitia]]. Dissections can be present in either one artery or several arteries concomitantly.<ref name="pmid12403896">{{cite journal |author=Choi JW, Davidson CJ |title=Spontaneous multivessel coronary artery dissection in a long-distance runner successfully treated with oral antiplatelet therapy |journal=[[The Journal of Invasive Cardiology]] |volume=14 |issue=11 |pages=675–8 |year=2002 |month=November |pmid=12403896 |doi= |url=}}</ref> The dissecting plane between [[intima]] and [[media]] creates a false lumen and the resulting [[hematoma]] compresses the vessel lumen causing [[myocardial ischemia]] or [[myocardial infarction]] (MI). | ||
Although intimal tear or bleeding of vasa vasorum with intramedial hemorrhage seems to be most probable reason, the exact underlying mechanism of non-atherosclerotic spontaneous coronary artery dissection (NA-SCAD) is still unknown [1]. Consequently intramural hematoma creates a false lumen [2]. Progressive expansion of the false lumen may cause subsequent myocardial ischemia and infarction. | |||
==References== | ==References== | ||
Revision as of 17:58, 22 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: Nate Michalak, B.A.
Synonyms and keywords: SCAD
Overview
Pathophysiology
At present the pathophysiology of SCAD continues to be poorly understood due to the rarity of this condition and its heterogeneous pathology. In SCAD the affected coronary artery develops a tear, causing blood to flow between the coronary arterial layers eventually forcing them apart. The pattern of dissection in SCAD is different from the pattern observed in patients with pre-existing atherosclerosis. In SCAD the plane of dissection lies within the outer third of the tunica media or between the media and adventitia. Dissections can be present in either one artery or several arteries concomitantly.[1] The dissecting plane between intima and media creates a false lumen and the resulting hematoma compresses the vessel lumen causing myocardial ischemia or myocardial infarction (MI).
Although intimal tear or bleeding of vasa vasorum with intramedial hemorrhage seems to be most probable reason, the exact underlying mechanism of non-atherosclerotic spontaneous coronary artery dissection (NA-SCAD) is still unknown [1]. Consequently intramural hematoma creates a false lumen [2]. Progressive expansion of the false lumen may cause subsequent myocardial ischemia and infarction.
References
- ↑ Choi JW, Davidson CJ (2002). "Spontaneous multivessel coronary artery dissection in a long-distance runner successfully treated with oral antiplatelet therapy". The Journal of Invasive Cardiology. 14 (11): 675–8. PMID 12403896. Unknown parameter
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