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Updated: Jun 22, 2026

Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model

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Spontaneous Coronary Dissection Review: A Complex Picture.

Mario Bollati¹, Vincenzo Ercolano¹, Pietro Mazzarotto¹

¹Cardiologia, Ospedale Maggiore, 26900 Lodi, Italy.

Reviews in Cardiovascular Medicine

|January 1, 2025

Summary

Spontaneous coronary artery dissection (SCAD) is rare but serious, often mimicking heart attacks. Diagnosis relies on invasive angiography, with conservative management preferred due to healing potential and revascularization risks.

Keywords:

SCAD dissection myocardial infarction

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Area of Science:

Cardiology
Vascular Medicine

Background:

Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS), frequently affecting younger individuals with atypical risk factors.
Misdiagnosis is common due to SCAD's presentation mimicking typical ACS, leading to delayed treatment.

Purpose of the Study:

To review the diagnostic and management strategies for SCAD.
To highlight the importance of accurate diagnosis and appropriate treatment to improve patient outcomes.

Main Methods:

Review of diagnostic modalities including coronary computed tomography (CT) and invasive coronary angiography (ICA).
Discussion of intravascular imaging (IVI) for enhanced diagnostic accuracy.
Analysis of SCAD classification systems and treatment approaches (conservative vs. revascularization).

Main Results:

Invasive coronary angiography (ICA) remains the gold standard for SCAD diagnosis, with IVI improving accuracy.
A conservative management approach is generally favored due to high spontaneous healing rates and risks associated with revascularization.
Revascularization via percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) is reserved for high-risk cases.

Conclusions:

Accurate and timely diagnosis of SCAD is crucial, utilizing ICA and IVI.
Conservative management is often preferred, with revascularization reserved for specific high-risk indications.
Long-term follow-up, screening for associated conditions, and psychological support are vital for SCAD patients.