Spontaneous Coronary Artery Dissection: An Underdiagnosed Clinical Entity-A Primer for Cardiac Imagers.

Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic cause of myocardial infarction in young and middle-aged women that has gained increasing awareness in recent years. Its diagnosis presents a challenge. Invasive coronary angiography is the primary imaging modality for diagnosing SCAD; however, it carries risk in these patients, who have an increased predisposition to complications.

Assessment of isotropic calcium using 0.5-mm reconstructions from 320-row CT data sets identifies more patients with non-zero Agatston score and more subclinical atherosclerosis than standard 3.0-mm coronary artery calcium scan and CT angiography.

Background: The presence of calcified plaque in coronary arteries can be quantified by using 0.5-mm isotropic reconstructions from 320-row CT without increased radiation dose. Little is known about reclassification of patients with non-zero Agatston scores and quantitative measures of calcified plaque using 0.