Spontaneous coronary artery dissection overview

Spontaneous Coronary Artery Dissection Microchapters
Home
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 (SCAD) is a rare, but under recognized cause of acute coronary syndrome and sudden cardiac death, which predominantly affects young, healthy women with few to no traditional cardiovascular risk factors.

Historical Perspective

The first case of spontaneous coronary artery dissection was described by Pretty in 1931.

Risk Factors

Multiple risk factors and precipitating stressors have been identified for SCAD, including fibromuscular dysplasia (FMD), connective tissue disorders, systemic inflammatory disorders, pregnancy and the peripartum state, hormonal therapy, and extreme physical exertion and/or emotional stress.

Natural History, Complications and Prognosis

Based on the limited outcomes data, SCAD survivors typically have a good long-term prognosis; however, there is an increased risk for recurrent SCAD events as well as other major cardiovascular events.

Diagnosis

Heightened awareness along with advances in intracoronary imaging techniques have led to an increase in the number of SCAD cases reported antemortem.

Treatment

In the majority of cases, conservative medical management is the optimal treatment strategy; however, based on the patient's clinical status and anatomy of the coronary dissection, revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) may be warranted.

Future or Investigational Therapies

Future studies are needed to further elucidate the underlying pathophysiology of this complex disorder as well as to gain a better understanding of the optimal treatment strategies and long-term outcomes of this unique patient population.