Pathophysiology of spontaneous coronary artery dissection: hematoma, not thrombus

Aleksandra Djokovic; Gordana Krljanac; Predrag Matic; Rastko Zivic; Vuk Djulejic; Marija Marjanovic Haljilji; Dusan Popovic; Branka Filipovic; Svetlana Apostolovic

doi:10.3389/fcvm.2023.1260478

Pathophysiology of spontaneous coronary artery dissection: hematoma, not thrombus

Front Cardiovasc Med. 2023 Oct 20:10:1260478. doi: 10.3389/fcvm.2023.1260478. eCollection 2023.

Authors

Aleksandra Djokovic^{1

2}, Gordana Krljanac^{1

3}, Predrag Matic^{1

4}, Rastko Zivic^{1

5}, Vuk Djulejic^{1

6}, Marija Marjanovic Haljilji⁷, Dusan Popovic^{1

7}, Branka Filipovic^{1

7}, Svetlana Apostolovic^{8

9}

Affiliations

¹ Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
² Department of Cardiology, University Hospital Center Bezanijska Kosa, Belgrade, Serbia.
³ Cardiology Clinic, University Clinical Center of Serbia, Belgrade, Serbia.
⁴ Clinic for Vascular Surgery, Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia.
⁵ Department for Surgery, Clinical Hospital Center Dr Dragisa Misovic "Dedinje", Belgrade Serbia.
⁶ Faculty of Medicine, Institute of Anatomy, Belgrade, Serbia.
⁷ Department for Gastroenterology, Clinical Hospital Center Dr Dragisa Misovic "Dedinje", Belgrade Serbia.
⁸ Coronary Care Unit, Cardiology Clinic, University Clinical Center of Nis, Nis, Serbia.
⁹ Faculty of Medicine, University of Nis, Nis, Serbia.

Abstract

Spontaneous coronary artery dissection (SCAD) accounts for 1.7%-4% of all acute coronary syndrome presentations, particularly among young women with an emerging awareness of its importance. The demarcation of acute SCAD from coronary atherothrombosis and the proper therapeutic approach still represents a major clinical challenge. Certain arteriopathies and triggers are related to SCAD, with high variability in their prevalence, and often, the cause remains unknown. The objective of this review is to provide contemporary knowledge of the pathophysiology of SCAD and possible therapeutic solutions.

Keywords: acute coronary syndrome; fibromuscular dysplasia; pathophysiology; pregnancy; spontaneous coronary artery dissection; women’s health.

Publication types

Review

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.