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Spontaneous Coronary Artery Dissection

Marysia S Tweet1, Rajiv Gulati2, Sharonne N Hayes2

  • 1Department of Internal Medicine, Division of Cardiovascular Diseases, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. tweet.marysia@mayo.edu.

Current Cardiology Reports
|May 25, 2016
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) is a key cause of heart attacks, especially in younger women. Advances in imaging reveal SCAD is more common than previously thought, requiring distinct management strategies.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Medical Imaging

Background:

  • Spontaneous coronary artery dissection (SCAD) is a significant cause of nonatherosclerotic acute coronary syndrome, myocardial infarction, and sudden death.
  • Previously underestimated, SCAD's prevalence is increasingly recognized due to technological advancements and heightened clinical awareness.

Purpose of the Study:

  • To review recent discoveries concerning SCAD.
  • To describe current research efforts aimed at addressing knowledge gaps in SCAD.
  • To emphasize the distinct clinical characteristics and management of SCAD compared to atherosclerotic heart disease.

Main Methods:

  • Review of recent literature and clinical findings related to SCAD.
  • Highlighting the role of advanced catheterization laboratory innovations.
  • Utilizing optical coherence tomography (OCT) and intravascular ultrasound (IVUS) for visualization.

Main Results:

  • Innovations like OCT and IVUS improve visualization of intimal disruption and intramural hematoma in SCAD.
  • Evidence suggests SCAD is more prevalent than previously estimated.
  • SCAD is frequently associated with female sex, young age, extreme stress or exertion, pregnancy, and fibromuscular dysplasia.

Conclusions:

  • SCAD requires specific consideration due to its unique patient demographics and clinical presentation.
  • Enhanced imaging technologies have improved SCAD diagnosis and understanding.
  • Further research is crucial to fully elucidate the pathophysiology and optimize management of SCAD.

Keywords:
Acute coronary syndromeFibromuscular dysplasiaMyocardial infarctionPregnancySpontaneous coronary artery dissectionWomen

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