[Spontaneous Coronary Artery Dissection].
N S Zhukova1, R M Shakhnovich1, I N Merkulova1
1National Medical Research Center for Cardiology.
Kardiologiia
|September 22, 2019
Summary
Spontaneous coronary artery dissection (SCAD) is increasingly recognized as a cause of acute coronary syndrome (ACS), particularly in younger women. This review covers SCAD
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Spontaneous coronary artery dissection (SCAD) was historically considered rare and linked to pregnancy.
- Increased awareness and diagnostic tools have revised views on SCAD prevalence.
Purpose of the Study:
- To review the pathogenesis, diagnostics, and treatment of SCAD.
- To discuss angiographic classifications and optimal management strategies for SCAD.
Main Methods:
- Literature review of studies on SCAD.
- Analysis of diagnostic modalities including high-sensitivity troponin and coronary angiography.
- Review of treatment approaches and management challenges.
Main Results:
- SCAD is a significant cause of acute coronary syndrome (ACS) in young and middle-aged women.
- Advances in diagnostics have improved SCAD identification.
- Various angiographic types of SCAD exist, influencing management.
Conclusions:
- SCAD is a crucial consideration for ACS, especially in younger women.
- Optimal management strategies for SCAD require further investigation.
- Continued research into SCAD pathogenesis and treatment is essential.
Related Concept Videos
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
367
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
367
01:30Acute Coronary Syndrome I: Introduction
844
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
844
01:26Coronary Artery Disease II: Pathophysiology
379
Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
379
01:30Coronary Artery Disease III: Clinical Manifestations
332
Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
332
01:30Coronary Artery Disease I: Introduction
900
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
900
01:30Acute Coronary Syndrome III: Diagnostic Studies
222
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
222