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| ==Diagnosis== | | ==Diagnosis== |
| [[Spontaneous coronary artery dissection history and symptoms|History and Symptoms]] | [[Spontaneous coronary artery dissection physical examination|Physical Examination]] | [[Spontaneous coronary artery dissection laboratory findings|Laboratory Findings]] | [[Spontaneous coronary artery dissection electrocardiogram|Electrocardiogram]] | [[Spontaneous coronary artery dissection angiography|Angiography]] | [[Spontaneous coronary artery dissection CT|CT]] | [[Spontaneous coronary artery dissection MRI|MRI]] | [[Spontaneous coronary artery dissection echocardiography|Echocardiography]] | [[Spontaneous coronary artery dissection other imaging findings|Other Imaging Findings]] | [[Spontaneous coronary artery dissection other diagnostic studies|Other Diagnostic Studies]] | | [[Spontaneous coronary artery dissection diagnostic approach|Diagnostic Approach]] | [[Spontaneous coronary artery dissection history and symptoms|History and Symptoms]] | [[Spontaneous coronary artery dissection physical examination|Physical Examination]] | [[Spontaneous coronary artery dissection laboratory findings|Laboratory Findings]] | [[Spontaneous coronary artery dissection electrocardiogram|Electrocardiogram]] | [[Spontaneous coronary artery dissection angiography|Angiography]] | [[Spontaneous coronary artery dissection CT|CT]] | [[Spontaneous coronary artery dissection MRI|MRI]] | [[Spontaneous coronary artery dissection echocardiography|Echocardiography]] | [[Spontaneous coronary artery dissection other imaging findings|Other Imaging Findings]] | [[Spontaneous coronary artery dissection other diagnostic studies|Other Diagnostic Studies]] |
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| ==Treatment== | | ==Treatment== |
| [[Spontaneous coronary artery dissection medical therapy|Medical Therapy]] | [[Spontaneous coronary artery dissection percutaneous coronary intervention|Percutaneous Coronary Intervention]] | [[Spontaneous coronary artery dissection surgery|Surgery]] | [[Spontaneous coronary artery dissection primary prevention|Primary Prevention]] | [[Spontaneous coronary artery dissection secondary prevention|Secondary Prevention]] | [[Spontaneous coronary artery dissection cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Spontaneous coronary artery dissection future or investigational therapies|Future or Investigational Therapies]] | | [[Spontaneous coronary artery dissection medical therapy|Medical Therapy]] | [[Spontaneous coronary artery dissection percutaneous coronary intervention|Percutaneous Coronary Intervention]] | [[Spontaneous coronary artery dissection surgery|Surgery]] | [[Spontaneous coronary artery dissection primary prevention|Primary Prevention]] | [[Spontaneous coronary artery dissection secondary prevention|Secondary Prevention]] | [[Spontaneous coronary artery dissection cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Spontaneous coronary artery dissection future or investigational therapies|Future or Investigational Therapies]] |
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| ==Management Algorithm for Spontaneous Coronary Artery Dissection <ref name="pmid25406203">{{cite journal| author=Tweet MS, Eleid MF, Best PJ, Lennon RJ, Lerman A, Rihal CS et al.| title=Spontaneous coronary artery dissection: revascularization versus conservative therapy. | journal=Circ Cardiovasc Interv | year= 2014 | volume= 7 | issue= 6 | pages= 777-86 | pmid=25406203 | doi=10.1161/CIRCINTERVENTIONS.114.001659 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25406203 }} </ref>==
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| {{Familytree/start}}
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| {{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | }}
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| {{Familytree |boxstyle=width: 1200px; font-size: 90%; padding: 0px;| | | | | | | | | A01 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | A01=<div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 10px;">'''Spontaneous Coronary Artery Dissection (SCAD)'''</div>}}
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| {{Familytree | | | |,|-|-|-|-|-|^|-|-|-|-|-|.| | | | | | | | | | | | | | | | | | | | | | | | | | }}
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| {{Familytree |boxstyle=width: 1200px; font-size: 90%; padding: 0px;| | B01 | | | | | | | | | | B02 | | | | | | | | | | | | | | | | | | | | | | | | | B01= <div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 10px;">'''Stable,no high-risk feature'''</div>|B02= <div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 10px;"> '''High-risk feature present'''</div>}}
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| {{familytree | | | |!| | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | |!| | | | | | | |,|-|-|-|^|-|-|-|v|-|-|-|v|-|-|-|.| | | | | | | | | | | | | | }}
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| {{familytree |boxstyle=width: 1200px; font-size: 90%; padding: 0px;| | | |!| | | | | | | C01 | | | | | | C02 | | C03 | | C04 | | | | | | | | | | | | | C01=<div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 30px;">Left main dissection</div>|C02=<div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 30px;">Ongoing/recurrent ischemia</div>|C03=<div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 20px;">Ventricular tachycardia or fibrillation</div>|C04=<div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 30px;">Cardiogenic shock</div>}}
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| {{familytree | | | |!| | | | | | | |!| | | | | | | |!| | | | | Z01 | | | | | | | | | | | | | | | Z01=Hemodynamically unstable?}}
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| {{familytree | | | |!| | | | | | | |!| | | | | | | |!| | | |,|-|^|-|.| | | | | | | | | | | | | | }}
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| {{familytree | | | |!| | | | | | | |!| | | | | | | |!| | | D01 | | D02 | | | | | | | | | | | | | D01=No | D02=Yes }}
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| {{familytree |boxstyle=width: 1200px; font-size: 90%; padding: 0px;| | | |!| | | | | | | |!| | | | | | | |!| | | |!| | | E01 | | | | | | | | | | | | | E01=<div style="text-align: center; background: #87CEFA; font-weight: bold; padding: 30px;">Consider: Intra-aortic balloon pump, Extra corporeal membrane oxygenation, Left ventricular assist device, Implantable cardioverter defibrillator</div>}}
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| {{familytree | | | |!| | | | | |,|-|^|-|.| | | | | |`|-|v|-|'| | | |!| | | | | | | | | | | | | | }}
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| {{familytree | | | |!| | | | | |!| | | |!| | | | | | | |!| | | | | |!| | | | | | | | | | | | | | }}
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| {{familytree |boxstyle=width: 1200px; font-size: 90%; padding: 0px;| | | |!| | | | | F01 | | F02 | | | | | | F03 |-|-|-|-|'| | | | | | | | | | | | | | F01= <div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 30px;">Isolated Left Main</div>|F02= <div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 10px;">Involving Left Anterior Descending (LAD +/or circumflex</div>| F03= <div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 30px;">Is percutaneous coronary intervention (PCI) feasible?</div>}}
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| {{familytree | | | |!| | | | | |!| | | |!| | | | | G01 | | | | G02 | | | | | | | | | | | | | | | G01=No | G02=Yes }}
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| {{familytree | | | |!| | | | | |!| | | |!| | | | | H01 | | | | |!| | | | | | | | | | | | | | | | H01 = Ostial LAD or ≥ 2 proximal SCAD?}}
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| {{familytree | | | I02 | | | | I03 | | |`|-|-| I01 | | I02 | | I03 | | | | | | | | | | | | | | | I01=Coronary artery bypassing | I02=Conservative therapy | I03=PCI}}
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| {{familytree | | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | | | | | | | | | | | J01 | | | | | | | | | | | | | | | | | | | | | | | | | | | J01='''Adjunctive medical therapy''' <BR> Aspirin and beta-blocker (± clopidogrel, ACEI/ARB, statin)}}
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| {{familytree | | | | | | | | | | | | | K01 | | | | | | | | | | | | | | | | | | | | | | | | | | | K01=Monitor in-hospital for 3 to 5 days}}
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