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Int J Cardiol. 2014 Jul 15;175(1):8-20. doi: 10.1016/j.ijcard.2014.04.178. Epub 2014 Apr 26.

Spontaneous coronary artery dissection.

Author information

1
Institute of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.
2
Institute of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy; ETNA Foundation, Catania, Italy. Electronic address: dcapodanno@gmail.com.
3
Department of Cardiology, Mount Sinai Medical Center, NY, United States; Cardiovascular Research Foundation, NY, United States.
4
Institute of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy; ETNA Foundation, Catania, Italy.

Abstract

Spontaneous coronary artery dissection (SCAD) is a relatively rare and unexplored type of coronary disease. Although atherosclerosis, hormonal changes during pregnancy and connective tissue disorders might represent a sufficiently convincing explanation for some patients with SCAD, the many remaining cases display only a weak relationship with these causes. While on one side the clinical heterogeneity of SCAD masks a full understanding of their underlying pathophysiologic process, on the other side paucity of data and misleading presentations hamper the quick diagnosis and optimal management of this condition. A definite diagnosis of SCAD can be significantly facilitated by endovascular imaging techniques. In fact, intravascular ultrasound (IVUS) and optical coherence tomography (OCT) overcome the limitations of coronary angiography providing detailed endovascular morphologic information. In contrast, optimal treatment strategies for SCAD still represent a burning controversial question. Herein, we review the published data examining possible causes and investigating the best therapy for SCAD in different clinical scenarios.

KEYWORDS:

Dissection; SCAD; Spontaneous coronary artery dissection

PMID:
24861255
DOI:
10.1016/j.ijcard.2014.04.178
[Indexed for MEDLINE]
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