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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Spontaneous coronary artery dissection: etiology and recurrence

Nicholas Y Tan1, Marysia S Tweet1

  • 1a Department of Cardiovascular Diseases , Mayo Clinic , Rochester , MN , USA.

Expert Review of Cardiovascular Therapy
|June 25, 2019
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) is a key cause of heart attacks in women. Further research into SCAD pathophysiology and prevention strategies is needed.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Spontaneous coronary artery dissection (SCAD) is an emerging cause of acute myocardial infarction (AMI) and sudden cardiac death.
  • SCAD predominantly affects young to middle-aged women with minimal traditional cardiovascular risk factors.

Purpose of the Study:

  • To review the clinical features, pathophysiology, and associated factors of SCAD.
  • To discuss the relationship between SCAD and fibromuscular dysplasia (FMD).
  • To outline current management and long-term follow-up strategies for SCAD.

Main Methods:

  • A comprehensive literature search was conducted using MedLine, PubMed, and Google Scholar up to April 30, 2019.

Main Results:

  • SCAD presents with distinct clinical features and is linked to other systemic vasculopathies like FMD.
  • Management involves acute care and long-term follow-up, including chest pain management and screening for extracoronary vasculopathy.
  • Recurrent SCAD risk and preventative strategies require further investigation.

Conclusions:

  • Understanding the association between SCAD and arteriopathies like FMD is expected to advance.
  • Predicting recurrent SCAD and developing preventative strategies, potentially using adjunctive imaging, are key future directions.

Keywords:
Spontaneous coronary artery dissectionacute coronary syndromefibromuscular dysplasiamyocardial infarctionwomen’s health

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