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Atherosclerotic Spontaneous Coronary Artery Dissection

Jung-In Choi1, Cathevine Yang2, Jacqueline Saw2

  • 1Division of Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

JACC. Case Reports
|March 28, 2023
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) typically affects those without atherosclerosis. This report details three unique SCAD cases occurring alongside existing atherosclerotic coronary artery disease.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Medical Case Studies

Background:

  • Spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic intimal tear in coronary arteries.
  • SCAD is generally considered to occur in the absence of atherosclerotic coronary artery disease (CAD).
  • The coexistence of SCAD and atherosclerosis presents a diagnostic and therapeutic challenge.

Observation:

  • This report presents three distinct cases of patients diagnosed with SCAD.
  • All three patients also exhibited evidence of underlying atherosclerotic coronary artery disease.
  • These cases represent a deviation from the typical presentation of SCAD.

Findings:

  • The study highlights the occurrence of SCAD in patients with pre-existing atherosclerotic CAD.
  • It underscores the potential for SCAD to manifest in the presence of atherosclerosis, challenging conventional understanding.
  • The findings suggest that atherosclerosis may not be an absolute exclusion criterion for SCAD.

Implications:

  • These cases broaden the clinical spectrum of SCAD.
  • Further research is warranted to elucidate the mechanisms underlying SCAD in atherosclerotic patients.
  • Clinicians should consider SCAD in patients with chest pain and risk factors for both SCAD and CAD.

Keywords:
acute coronary syndromeatherosclerosisdissection

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