Spontaneous coronary artery dissection: an overview

Postgrad Med J. 2023 Nov 20;99(1178):1226-1236. doi: 10.1093/postmj/qgad086.

Abstract

The prevalence of spontaneous coronary artery dissection (SCAD) has increased over the last decades in young adults presenting with acute coronary syndrome. Although the diagnostic tools, including intracoronary imaging, have permitted a more accurate diagnosis of SCAD, the prognosis and overall outcomes remain dismal. Furthermore, the disproportionate sex distribution affecting more women and the underdiagnosis in many parts of the world render this pathology a persistent clinical challenge, particularly since the management remains largely supportive with a limited and controversial role for percutaneous or surgical interventions. The purpose of this review is to summarize the available literature on SCAD and to provide insights into the gaps in knowledge and areas requiring further investigation.

Keywords: SCAD; acute coronary syndrome; false lumen; genetics; intima; intramural hematoma; myocardial injury; scaffold.

Publication types

  • Review

MeSH terms

  • Coronary Angiography
  • Coronary Vessel Anomalies* / diagnostic imaging
  • Coronary Vessel Anomalies* / epidemiology
  • Coronary Vessels
  • Female
  • Humans
  • Prognosis
  • Vascular Diseases* / diagnostic imaging
  • Vascular Diseases* / therapy
  • Young Adult

Supplementary concepts

  • Coronary Artery Dissection, Spontaneous

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