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Related Concept Videos

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
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Coronary Artery Disease II: Pathophysiology01:26

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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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Acute Coronary Syndrome I: Introduction01:30

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Peripheral Artery Disease I: Introduction01:30

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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs but also impacts other areas, such as the arms, thereby impairing overall circulation and organ function.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty deposits inside the arterial...
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Coronary Artery Disease I: Introduction01:30

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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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Spontaneous coronary artery dissection: an unpredictable event.

Alexandra Smirnova1, Flaminia Aliberti1, Claudia Cavaliere1

  • 1Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

European Heart Journal Supplements : Journal of the European Society of Cardiology
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PubMed
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Spontaneous coronary artery dissection (SCAD) predominantly affects women, causing acute coronary syndromes. Further research is crucial for effective prevention, diagnosis, and treatment of this unpredictable condition.

Keywords:
Fibromuscular dysplasiaGeneticsPregnancy-related deathSpontaneous coronary artery dissection

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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.