AI Article Synopsis
- Spontaneous coronary artery dissection (SCAD) is a rare but important cause of heart attacks (MI) primarily affecting young and middle-aged women, especially during pregnancy, with over 90% of cases in women.
- Unlike atherosclerosis-related heart attacks, SCAD patients typically have fewer cardiovascular risk factors but may have conditions like fibromuscular dysplasia and are identified by distinct findings on coronary angiography, such as intramural hematomas.
- Treatment for SCAD generally involves conservative management rather than invasive procedures, as affected vessels often heal on their own, highlighting the need for more research to establish effective treatment and prevention methods.
Article Abstract
Spontaneous coronary artery dissection (SCAD) is an uncommon but increasingly recognized cause of acute myocardial infarction (MI) among young and middle-aged women and is an important cause of pregnancy-associated MI. Over 90% of SCAD patients are women. Compared to patients with MI caused by atherosclerosis, SCAD patients have fewer cardiovascular risk factors but more often have systemic arteriopathy, most commonly fibromuscular dysplasia. Angiographically, SCAD is characterized by the presence of an intramural hematoma with or without an intimal tear. Accurate recognition of characteristic findings on coronary angiography is critical, as there are important differences in the acute and long-term management of MI caused by SCAD versus atherosclerosis. Acutely, most SCAD patients should be managed conservatively, since percutaneous revascularization is associated with more complications and SCAD-affected vessels usually heal without intervention. Randomized clinical trials and other prospective evaluations are needed, especially to clarify optimal treatment and prevention strategies.
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| http://dx.doi.org/10.1146/annurev-med-052819-023826 | DOI Listing |
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Article Synopsis
- Despite progress in recognizing and diagnosing spontaneous coronary artery dissection (SCAD) in the last decade, there is still limited understanding of its mechanisms, contributing factors, and effective treatments.
- The text highlights research gaps in SCAD and suggests strategies like patient advocacy, independent registries, and specialized centers to improve clinical care and research outcomes.
- Additionally, it presents a patient-centered clinical care and research framework developed by the SCAD Alliance and International SCAD registry as a model to enhance understanding and management of this condition.
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