Spontaneous Coronary Artery Dissection: Cardiac Manifestations of Vascular Disease

Prog Cardiovasc Dis. 2018 Mar-Apr;60(6):629-634. doi: 10.1016/j.pcad.2018.04.001. Epub 2018 Apr 6.

Abstract

Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome (ACS) in young women who otherwise do not have traditional risk factors for coronary artery disease. Though previously considered to be a rare occurrence and primarily associated with pregnancy, contemporary series have demonstrated that SCAD may account for 35% of ACS in women under the age of 50 years, and peripartum SCAD accounts for the minority of cases. Importantly, an association between SCAD and arterial abnormalities in non-coronary arterial distributions has been described. The most common of these arterial abnormalities is fibromuscular dysplasia. This manuscript will briefly review the epidemiology, diagnosis, and treatment of SCAD and provide an overview of how SCAD may be a cardiac manifestation of an underlying vascular disease in the majority of patients.

Keywords: Aneurysm; Arterial dissection; Arteriopathy; Fibromuscular dysplasia; Spontaneous coronary artery dissection.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / diagnostic imaging
  • Acute Coronary Syndrome / etiology*
  • Acute Coronary Syndrome / mortality
  • Adult
  • Age Factors
  • Aged
  • Cause of Death*
  • Computed Tomography Angiography / methods
  • Coronary Vessel Anomalies / diagnostic imaging*
  • Coronary Vessel Anomalies / mortality*
  • Coronary Vessel Anomalies / therapy
  • Female
  • Fibromuscular Dysplasia / complications*
  • Fibromuscular Dysplasia / diagnosis
  • Fibromuscular Dysplasia / therapy
  • Humans
  • Magnetic Resonance Angiography / methods
  • Male
  • Middle Aged
  • Risk Assessment
  • Sex Factors
  • Survival Rate
  • Tomography, Optical Coherence / methods
  • Vascular Diseases / congenital*
  • Vascular Diseases / diagnostic imaging
  • Vascular Diseases / mortality
  • Vascular Diseases / therapy

Supplementary concepts

  • Coronary Artery Dissection, Spontaneous