Contemporary diagnosis and management of spontaneous coronary artery dissection

Spontaneous coronary artery dissection (SCAD) has emerged over the last decade as an increasingly recognised cause of myocardial infarction, especially among younger women. The advances in our understanding of SCAD and the evolution of coronary angiography and intracoronary imaging have led to improved diagnoses and outcomes; however, there are still knowledge gaps and challenges in the management of this condition. In this review, we summarise the pathogenesis, genetics, diagnosis and acute and chronic management of patients with SCAD. We also provide focused updates on the following: genetics of SCAD, the role of cardiac CT angiography and cardiac MRI, the use of intracoronary imaging, revascularisation techniques and the overlap between SCAD and Takotsubo syndrome.