Spontaneous Coronary Artery Dissection Case Series: Clinical Presentation, Angiographic Imaging, Management, and...

Spontaneous coronary artery dissection (SCAD) is a rare but more frequently recognized cause of acute coronary syndrome. Due to the low incidence rate of this condition, there are no consensus guidelines to treat this clinical entity. Most of the information on the clinical presentation and management of SCAD originates from case reports and series; however, there has not been yet a prospective randomized study to guide treatment of SCAD. It is mostly seen in women and particularly those of younger ages. Most cases have an underlying etiology although the underlying pathophysiology is not fully understood. Patients might present in various ways including chest pain, ST- elevation acute coronary syndrome, ventricular arrhythmia, and sudden cardiac death. Although conservative management is mostly recommended with better outcomes, revascularization should be considered in certain circumstances. In this article, we describe a case series of five patients with SCAD. Additionally, this article reviews clinical presentation, incidence, diagnostic modalities, management and risk of recurrences in patients diagnosed with SCAD.