Abstract
Spontaneous coronary artery dissection (SCAD) is a poorly understood and under-diagnosed entity of acute coronary syndrome, affecting predominantly young women. On coronary angiography, the diagnosis remains challenging, particularly in case of intramural hematoma without intimal rupture. Intracoronary imaging, especially by optical coherence tomography (OCT), provides an incremental value in terms of diagnosis and management. We report the case of a 49-year-old woman admitted for STEMI caused by an intramural hematoma. In the discussion part, we aim to review the epidemiology, physiopathology, diagnosis, management and long-term prognosis of SCAD.
Keywords:
Acute coronary syndrome; Dissection coronaire spontanée; Hématome pariétal; Intramural hematoma; Optical coherence tomography (OCT); Spontaneous coronary artery dissection (SCAD); Syndrome coronarien aigu; Tomographie par cohérence optique (OCT).
Copyright © 2015 Elsevier Masson SAS. All rights reserved.
MeSH terms
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Adrenergic beta-Antagonists / therapeutic use
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Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
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Anticoagulants / therapeutic use
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Coronary Vessel Anomalies / complications
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Coronary Vessel Anomalies / diagnosis*
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Coronary Vessel Anomalies / drug therapy
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Drug Therapy, Combination
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Female
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Heart Conduction System / physiopathology
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Hematoma / diagnosis*
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Hematoma / drug therapy
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Hematoma / etiology
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Humans
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Middle Aged
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Myocardial Infarction / diagnosis*
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Myocardial Infarction / drug therapy
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Myocardial Infarction / etiology
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Myocardial Infarction / physiopathology
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Prognosis
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Risk Factors
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Smoking / adverse effects
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Tomography, Optical Coherence* / methods
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Treatment Outcome
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Vascular Diseases / complications
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Vascular Diseases / congenital*
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Vascular Diseases / diagnosis
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Vascular Diseases / drug therapy
Substances
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Adrenergic beta-Antagonists
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Anti-Inflammatory Agents, Non-Steroidal
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Anticoagulants
Supplementary concepts
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Coronary Artery Dissection, Spontaneous