Spontaneous coronary artery dissection

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., Arzu Kalayci, M.D. [2]

Synonyms and keywords: SCAD

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Angiography | CT | MRI | Echocardiography | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Percutaneous Coronary Intervention | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Management Algorithm for Spontaneous Coronary Artery Dissection

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