Contemporary Review on Spontaneous Coronary Artery Dissection

J Am Coll Cardiol. 2016 Jul 19;68(3):297-312. doi: 10.1016/j.jacc.2016.05.034.

Abstract

Spontaneous coronary artery dissection (SCAD) is gaining recognition as an important cause of myocardial infarction, especially in young women. There has been a surge in the diagnosis of SCAD in recent years, presumably due to an increased use of coronary angiography, and the clinical availability and application of high-resolution intracoronary imaging. The improved recognition and diagnosis, together with increased publications and attention through social media, have considerably raised awareness of this condition, which was once believed to be very rare. Recent publications of moderate to large contemporary case series have helped elucidate the early natural history, presenting characteristics (clinical and angiographic), underlying etiology, management, and cardiovascular outcomes with this condition, thus providing observations and important clinical insights of value to clinicians managing this challenging and perplexing patient cohort. The aim of our review is to provide a comprehensive contemporary update of SCAD to aid health care professionals in managing these patients in both the acute and chronic settings.

Keywords: fibromuscular dysplasia; myocardial infarction; women.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Coronary Angiography
  • Coronary Vessel Anomalies* / complications
  • Coronary Vessel Anomalies* / diagnosis
  • Coronary Vessel Anomalies* / therapy
  • Disease Management*
  • Humans
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / etiology*
  • Ultrasonography, Interventional
  • Vascular Diseases / complications
  • Vascular Diseases / congenital*
  • Vascular Diseases / diagnosis
  • Vascular Diseases / therapy

Supplementary concepts

  • Coronary Artery Dissection, Spontaneous