The growing use of imaging examinations has led to increased detection of spontaneous coronary artery dissection (SCAD) as a non-atherosclerotic cause of acute coronary syndrome (ACS). Since a greater awareness of pathophysiologic mechanisms has relevant implications in clinical practice, we aim to provide an update to current knowledge of SCAD pathophysiology. We discuss the most common conditions associated with SCAD, including predisposing factors and triggers, and focus on potential mechanisms leading to SCAD development. Furthermore, we report the main genetic research findings that have shed further light on SCAD pathophysiology. Finally, we summarize practical considerations in SCAD management based on pathophysiologic insights.
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http://dx.doi.org/10.1016/j.tcm.2021.01.002 | DOI Listing |
J Clin Med
January 2025
Department of Cardiac Surgery, The Pope John Paul II Province Hospital of Zamość, 22-400 Zamosc, Poland.
Removal of spontaneously fractured leads with their proximal ends migrated into the vascular space has not been analysed in detail thus far. The study aimed to compare the effectiveness of different approaches and auxiliary tools for removing fractured leads with migrated proximal ends. Retrospective analysis of 72 cases from a database containing 3847 TLEs (transvenous lead extraction).
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Cardiology, Umberto I Hospital, 84014 Nocera Inferiore, Italy.
Heart and lung sharing the same anatomical space are influenced by each other. Spontaneous breathing induces dynamic changes in intrathoracic pressure, impacting cardiac function, particularly the right ventricle. In intensive care units (ICU), mechanical ventilation (MV) and therefore positive end-expiratory pressure (PEEP) are often applied, and this inevitably influences cardiac function.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2024
Internal Medicine Department, Faculty of Medicine, Ovidius University of Constanta, 145 Tomis Boulevard, 900591 Constanta, Romania.
Spontaneous coronary artery dissection is a rare cause of unstable angina, myocardial infarction, and sudden cardiac death, particularly among young women and individuals without conventional atherosclerotic risk factors. We present the case of a 43-year-old woman who had spontaneous coronary artery dissection involving the left main with extension to left anterior descending artery and left circumflex artery. She was ultimately managed medically, with a good outcome.
View Article and Find Full Text PDFCells
December 2024
Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, National Institute of Health, Baltimore, MD 21224, USA.
The spontaneous firing of the sinoatrial (SA) node, the physiological pacemaker of the heart, is generated within sinoatrial nodal cells (SANCs) and is regulated by a "coupled-clock" pacemaker system, which integrates a "membrane clock", the ensemble of ion channel currents, and an intracellular "Ca clock", sarcoplasmic reticulum-generated local submembrane Ca releases via ryanodine receptors. The interactions within a "coupled-clock" system are modulated by phosphorylation of surface membrane and sarcoplasmic reticulum proteins. Though the essential role of a high basal cAMP level and PKA-dependent phosphorylation for basal spontaneous SANC firing is well recognized, the role of basal CaMKII-dependent phosphorylation remains uncertain.
View Article and Find Full Text PDFInt J Emerg Med
January 2025
Departamento de Cardiología, Fundación Valle del Lili, Carrera 98 No. 18 - 49, Cali, 760032, Colombia.
Background: Penetrating cardiac trauma is an entity with high pre and intrahospital mortality due to complications such as cardiac tamponade and massive hemothorax. A ventricular septal defect (VSD) occurs in 1-5% of cases and can present early or late. The management strategy for VSD resulting from penetrating cardiac trauma is uncertain.
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