Spontaneous coronary artery dissection diagnostic approach: Difference between revisions
Jump to navigation
Jump to search
/* Management Algorithm for Spontaneous Coronary Artery Dissection {{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. |... |
/* Management Algorithm for Spontaneous Coronary Artery Dissection {{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. |... |
||
| Line 21: | Line 21: | ||
{{familytree | | | |!| | | | | | | | | | | |!|}} | {{familytree | | | |!| | | | | | | | | | | |!|}} | ||
{{familytree | | | |!| | | | | | | |,|-|-|-|^|-|-|-|v|-|-|-|v|-|-|-|.|}} | {{familytree | | | |!| | | | | | | |,|-|-|-|^|-|-|-|v|-|-|-|v|-|-|-|.|}} | ||
{{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: | {{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: 10px;">Left main dissection</div>|C02=<div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 10px;">Ongoing/recurrent ischemia</div>|C03=<div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 10px;">Ventricular tachycardia or fibrillation</div>|C04=<div style="text-align: center; background: #FFF0F5; font-weight: bold; padding: 10px;">Cardiogenic shock</div>}} | ||
{{familytree | | | |!| | | | | | | |!| | | | | | | |!| | | |`|-|v|-|'|}} | {{familytree | | | |!| | | | | | | |!| | | | | | | |!| | | |`|-|v|-|'|}} | ||
{{familytree | | | |!| | | | | | | |!| | | | | | | |!| | | | | |!| }} | {{familytree | | | |!| | | | | | | |!| | | | | | | |!| | | | | |!| }} | ||
Revision as of 23:46, 1 December 2017
|
Spontaneous Coronary Artery Dissection Microchapters |
|
Differentiating Spontaneous coronary artery dissection from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
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
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.