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Spontaneous coronary artery dissection: current insights and therapy
W Tanis1, P R Stella, J H Kirkels
1Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Summary
Spontaneous coronary artery dissection (SCAD) is a rare heart condition primarily affecting young women. This review discusses SCAD mechanisms, treatment, and prognosis, highlighting the need for hospitalization due to recurrence risk.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndromes.
- It predominantly affects young, healthy females.
- Associated conditions include atherosclerosis, connective tissue disorders, and peripartum factors.
Purpose of the Study:
- To review the literature on SCAD.
- Discuss potential mechanisms, therapeutic options, and prognosis.
- Illustrate with cases of recurrent SCAD.
Main Methods:
- Literature review.
- Case illustration of two patients with recurrent SCAD.
Main Results:
- SCAD recurrence in different arteries occurred within days in illustrated cases.
- Primary percutaneous coronary intervention is the preferred reperfusion strategy.
- Conservative treatment is viable for small/medium arteries with normal flow.
Conclusions:
- A minimum one-week hospital observation is proposed due to recurrence susceptibility.
- Post-acute phase evaluation for underlying conditions is crucial for guiding treatment.
- Both conservative and invasive strategies are discussed for acute SCAD management.
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