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