Spontaneous coronary artery dissection, challenges of diagnosis and management

Future Cardiol. 2017 Nov;13(6):539-549. doi: 10.2217/fca-2017-0050. Epub 2017 Oct 24.

Abstract

Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome in young patients. No clear factors exist to predict the natural history of the disease and the prognosis of the condition. Furthermore, current management practice of SCAD is based mainly on retrospective data and case series and clear management guidelines are lacking. In this article, we present a series of cases of patients with SCAD and we will discuss the different clinical presentations, the diagnostic approaches and the options of management of this cohort of patients. Our aim is to outline the challenges of diagnosis and management of this interesting and serious pathology.

Keywords: acute coronary syndrome; intravascular ultrasound; optical coherence tomography; percutaneous coronary artery intervention; spontaneous coronary artery dissection.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / complications
  • Acute Coronary Syndrome / diagnostic imaging
  • Acute Coronary Syndrome / drug therapy*
  • Adult
  • Angioplasty, Balloon, Coronary / instrumentation
  • Angioplasty, Balloon, Coronary / methods*
  • Cardiac Catheterization / methods
  • Chest Pain / diagnosis
  • Chest Pain / etiology
  • Coronary Angiography / methods
  • Coronary Vessel Anomalies / diagnostic imaging*
  • Coronary Vessel Anomalies / drug therapy*
  • Electrocardiography / methods
  • Emergency Service, Hospital
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Risk Assessment
  • Sampling Studies
  • Severity of Illness Index
  • Stents*
  • Tomography, Optical Coherence / methods
  • Treatment Outcome
  • Ultrasonography, Interventional / methods
  • Vascular Diseases / congenital*
  • Vascular Diseases / diagnostic imaging
  • Vascular Diseases / drug therapy

Supplementary concepts

  • Coronary Artery Dissection, Spontaneous