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Spontaneous Coronary Artery Dissection (SCAD) from an Interventionalist Perspective
Nichole Brunton1, Patricia J M Best2, Kimberly A Skelding3
1Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, 200 1st St SW, Rochester, MN, 55905, USA.
Current Cardiology Reports
|January 18, 2024
Summary
Spontaneous coronary artery dissection (SCAD) is a key cause of heart attacks in women. Current evidence supports conservative management for SCAD, with invasive strategies reserved for specific complications.
Area of Science:
- Cardiology
- Vascular Biology
- Women's Health
Background:
- Spontaneous coronary artery dissection (SCAD) is an emerging cause of acute coronary syndrome (ACS).
- SCAD disproportionately affects women under 50.
- SCAD can be an early indicator of systemic arterial disease.
Purpose of the Study:
- To review the pathogenesis of SCAD.
- To discuss SCAD as a manifestation of systemic arterial disease.
- To highlight management strategies and challenges in women with SCAD.
Main Methods:
- Literature review of SCAD pathogenesis, clinical presentation, and management.
- Analysis of current treatment paradigms, including conservative vs. invasive approaches.
- Identification of specific patient populations at higher risk.
Main Results:
- A shift towards conservative management for SCAD is evident.
- Invasive interventions are reserved for hemodynamically unstable patients due to higher risks.
- Premenopausal women, those with connective tissue disease, and pregnancy-associated SCAD (P-SCAD) represent high-risk groups.
Conclusions:
- Conservative management is the current standard for SCAD.
- Further research is needed on genetic factors, optimal medical therapy, and interventional techniques.
- Evidence-based data on SCAD, particularly in women, remains limited.
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