Spontaneous coronary artery dissection: clinical implications and diagnostic challenges. Overlooked and...

Area of Science:

• Cardiology
• Vascular Biology
• Medical Case Studies

Background:

• Spontaneous Coronary Artery Dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome (ACS), particularly in younger women without traditional cardiovascular risk factors.
• SCAD research has been predominantly Western-centric, leading to potential under-diagnosis and under-representation in Asian populations.
• Understanding SCAD's unique epidemiology and clinical manifestations in diverse ethnic groups is crucial for improving patient outcomes.

Observation:

• This review presents two distinct cases of SCAD in Singaporean women of Malay and Chinese descent.
• The cases illustrate that pregnancy-associated SCAD is not the sole or most frequent presentation.
• SCAD presentations are heterogeneous, and associations with connective tissue disorders like fibromuscular dysplasia warrant attention.

Findings:

• SCAD diagnosis remains challenging for many cardiologists, often requiring a high index of suspicion.
• Coronary angiography interpretation and the utility of intracoronary imaging are critical for accurate SCAD diagnosis.
• Effective management necessitates a multidisciplinary team approach and tailored recovery programs.

Implications:

• Increased awareness and research into SCAD in Asian populations are essential for enhancing diagnostic accuracy and treatment strategies.
• Developing specialized recovery programs incorporating support groups, allied health, and cardiac rehabilitation is vital for long-term patient well-being.
• Addressing the diagnostic and management complexities of SCAD can improve outcomes for affected individuals, especially in under-represented demographics.