Open AccessSpontaneous coronary artery dissection
Author(s) -
Almeda Francis Q.,
Barkatullah Sameer,
Kavinsky Clifford J.
Publication year - 2004
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960270702
Subject(s) - medicine , scad , coronary artery disease , cardiology , revascularization , percutaneous coronary intervention , dissection (medical) , acute coronary syndrome , ischemia , artery dissection , disease , pathophysiology , surgery , myocardial infarction , coronary angiography
Spontaneous coronary artery dissection (SCAD) is an unusual cause of acute myocardial ischemia with complex pathophysiology. This paper reviews the major diagnostic and therapeutic issues of this rare but important disease. The diagnosis of SCAD should be strongly considered in any patient who presents with symptoms suggestive of acute myocardial ischemia, particularly in young subjects without traditional risk factors for coronary artery disease (especially in young women during the peripartum period or in association with oral contraceptive use). Urgent coronary angiography is indicated to establish the diagnosis and to determine the appropriate therapeutic approach. The decision to pursue medical management, percutaneous coronary intervention, or surgical revascularization is based primarily on the clinical presentation, extent of dissection, and amount of ischemic myocardium at risk.