Spontaneous coronary artery dissection diagnostic approach: Difference between revisions

	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;

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Revision as of 13:58, 28 November 2017

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

Diagnostic Approach

Management Algorithm for Spontaneous Coronary Artery Dissection ^[1]

Spontaneous Coronary Artery Dissection (SCAD)

Stable,no high-risk feature

High-risk feature present

Left main dissection

Ongoing/recurrent ischemia

Ventricular tachycardia or fibrillation

Cardiogenic shock

Hemodynamically unstable?

No

Yes

Consider: Intra-aortic balloon pump, Extra corporeal membrane oxygenation, Left ventricular assist device, Implantable cardioverter defibrillator

Isolated Left Main

Involving Left Anterior Descending (LAD +/or circumflex

Is percutaneous coronary intervention (PCI) feasible?

No

Yes

Ostial LAD or ≥ 2 proximal SCAD?

Conservative therapy

PCI

Coronary artery bypassing

Conservative therapy

PCI

Adjunctive medical therapy
Aspirin and beta-blocker (± clopidogrel, ACEI/ARB, statin)

Monitor in-hospital for 3 to 5 days

References

↑ Tweet MS, Eleid MF, Best PJ, Lennon RJ, Lerman A, Rihal CS; et al. (2014). "Spontaneous coronary artery dissection: revascularization versus conservative therapy". Circ Cardiovasc Interv. 7 (6): 777–86. doi:10.1161/CIRCINTERVENTIONS.114.001659. PMID 25406203.

[pmid25406203-1] Tweet MS, Eleid MF, Best PJ, Lennon RJ, Lerman A, Rihal CS; et al. (2014). "Spontaneous coronary artery dissection: revascularization versus conservative therapy". Circ Cardiovasc Interv. 7 (6): 777–86. doi:10.1161/CIRCINTERVENTIONS.114.001659. PMID 25406203.

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@@ Line 11: / Line 11: @@
 ==Diagnostic Approach==
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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 |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 | | | |!| | | | | | | |!| | | | | | | |!| | | 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 |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 | | | | | | | | | | | | | K01 | | | | | | | | | | | | | | | | | | | | | | | | | | | K01=Monitor in-hospital for 3 to 5 days}}
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 ==References==

Spontaneous coronary artery dissection diagnostic approach: Difference between revisions

Revision as of 13:58, 28 November 2017

Overview

Diagnostic Approach

Management Algorithm for Spontaneous Coronary Artery Dissection [1]

References

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Management Algorithm for Spontaneous Coronary Artery Dissection ^[1]