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Role of Coronary CT Angiography in Spontaneous Coronary Artery Dissection

Sumit Gupta1, Nandini M Meyersohn1, Malissa J Wood1

  • 1Department of Radiology, Cardiovascular Division (S.G., N.M.S., B.B.G., S.S.H.), and Department of Medicine, Cardiology Division (M.J.W.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; Department of Radiology (M.L.S.) and Department of Medicine, Cardiovascular Division (R.B.), Brigham and Women's Hospital, Boston, Mass.

Radiology. Cardiothoracic Imaging
|March 29, 2021
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) is a significant cause of heart attacks in younger women. Coronary CT angiography offers a safe and effective noninvasive method for diagnosing SCAD.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Spontaneous coronary artery dissection (SCAD) is increasingly recognized as a cause of acute coronary syndrome, particularly in young women without traditional atherosclerotic risk factors.
  • SCAD accounts for up to 4% of acute coronary syndrome cases.
  • It is a leading cause of myocardial infarction in young individuals.

Purpose of the Study:

  • To evaluate the utility of coronary CT angiography (CCTA) as a noninvasive imaging modality for assessing SCAD.
  • To highlight the advantages of new-generation CT scanners in SCAD diagnosis.

Main Methods:

  • Review of CCTA findings in patients with suspected SCAD.
  • Comparison of CCTA characteristics with invasive coronary angiography where available.
  • Assessment of advancements in CT scanner technology, including improved resolution and reduced radiation dose.

Main Results:

  • New-generation CT scanners offer enhanced spatial and temporal resolution with reduced radiation exposure.
  • CCTA demonstrates effectiveness in visualizing coronary artery dissections.
  • The risk of dissection propagation during invasive procedures is a consideration.

Conclusions:

  • Coronary CT angiography is a valuable noninvasive tool for SCAD assessment.
  • Improved CT technology enhances diagnostic capabilities for SCAD.
  • Conservative management is often preferred for SCAD, making noninvasive imaging crucial.

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