Spontaneous coronary artery dissection: an unpredictable event

Area of Science:

• Cardiology
• Vascular Medicine
• Women's Health

Background:

• Spontaneous coronary artery dissection (SCAD) is an under-recognized cause of acute coronary syndrome (ACS).
• SCAD predominantly affects women and is a leading cause of myocardial infarction during pregnancy.
• Associated factors include oral contraceptives, hormone therapy, and infertility treatments.

Purpose of the Study:

• To highlight the under-recognized nature of SCAD.
• To discuss the clinical presentations, risk factors, and pathological substrates of SCAD.
• To emphasize the unmet clinical need for improved prevention, diagnosis, and treatment strategies.

Main Methods:

• Review of existing literature on SCAD.
• Analysis of clinical presentations, prevalence, and associated factors.
• Discussion of pathological substrates and genetic etiologies.

Main Results:

• SCAD commonly presents as ST-elevation myocardial infarction (STEMI) or non-STEMI.
• Prevalence remains uncertain due to underdiagnosis.
• Recurrence rates vary up to 30%, and outcomes are unpredictable.

Conclusions:

• SCAD is a significant cause of ACS in women, often linked to fibromuscular dysplasia and emotional stress.
• Genetic factors are implicated in a subset of cases.
• Optimal treatment strategies require further investigation to improve patient outcomes.