Spontaneous coronary artery dissection: A review for clinical and interventional cardiologists

Catarina Brízido, Sérgio Madeira, Cláudia Silva, Christopher Strong, António Tralhão, Manuel Almeida

Research output: Contribution to journalReview articlepeer-review

4 Citations (Scopus)
24 Downloads (Pure)

Abstract

Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome, especially among young to middle-aged women with few traditional cardiovascular risk factors and low pretest probability for atherosclerotic coronary artery disease. Diagnosis by invasive coronary angiography is the gold standard and conservative therapy is generally recommended, with percutaneous or surgical revascularization being reserved for cases of clinical instability, high-risk anatomy or as bailout. Unlike atherothrombotic coronary artery disease, strong evidence on optimal medical therapy is scarce, posing unique challenges in cases of pregnancy-associated SCAD. The follow-up strategy is also of major importance, as recurrent SCAD is not infrequent, lifestyle changes and pharmacological therapy should be planned for the long term, and SCAD-associated conditions need to be addressed. This review aims to provide a practical management approach to SCAD patients for both clinical and interventional cardiologists.

Original languageEnglish
Pages (from-to)269-276
JournalRevista Portuguesa de Cardiologia
Early online date9 Jan 2023
DOIs
Publication statusPublished - Mar 2023

Keywords

  • Acute coronary syndrome
  • Fibromuscular dysplasia
  • MINOCA
  • ercutaneous coronary intervention
  • Pregnancy
  • Spontaneous coronary artery dissection
  • Woman

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