Multivessel spontaneous coronary artery dissection associated with hormonal infertility therapy in a 39-year-old female

Hardegree, Evan L.; Tweet, Marysia S.; Hayes, Sharonne N.; Gulati, Rajiv; Kane, Garvan C.

doi:10.1016/j.jccase.2012.01.003

Cited by 11 publications

(7 citation statements)

References 10 publications

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“…6,29,125–127,131 The biggest challenge for confirming any of these correlations is that the baseline prevalence of these conditions is either common in the general population or unknown.…”

Section: Pathogenesis Of Scad and Scad-associated Conditionsmentioning

confidence: 99%

Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association

Hayes¹,

Kim²,

Saw³

et al. 2018

Circulation

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894

1,344

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Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction. High rates of recurrent SCAD; its association with female sex, pregnancy, and physical and emotional stress triggers; and concurrent systemic arteriopathies, particularly fibromuscular dysplasia, highlight the differences in clinical characteristics of SCAD compared with atherosclerotic disease. Recent insights into the causes of, clinical course of, treatment options for, outcomes of, and associated conditions of SCAD and the many persistent knowledge gaps are presented.

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Section: Pathogenesis Of Scad and Scad-associated Conditionsmentioning

confidence: 99%

Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association

Hayes¹,

Kim²,

Saw³

et al. 2018

Circulation

Self Cite

894

1,344

View full text Add to dashboard Cite

show abstract

“…However, SCAD did not appear to have familial inheritance [17]. The reported triggering factors involve high physical and emotional stress, straining [18], high-dose corticosteroids [19], oral contraceptive pills [20], and infertility treatment [21].…”

Section: Etiologymentioning

confidence: 93%

Spontaneous Coronary Artery Dissection; A Literature Review

Elkammash¹,

Khan²

2022

JCCI

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Spontaneous coronary artery dissection (SCAD) is the spontaneous splitting of the coronary tunica media with the formation of a false lumen in the vessel wall and compression of the true lumen. Its incidence is often underestimated, especially in cases of sudden cardiac death before coronary angiography. Predisposing factors include pregnancy, systemic arteriopathy (such as fibromuscular dysplasia), systemic inflammatory conditions ( such as systemic lupus erythematosus and polyarteritis nodosa), systemic connective tissue diseases ( such as Marfan and Ehlers-Danlos syndromes), hypertension and migraine. Common triggering factors involve straining, stress, and hormonal treatment. SCAD is usually diagnosed through coronary angiography, with CT coronary angiography as a non-invasive diagnostic tool. Experts advise minimal coronary instrumentation due to vessel fragility and the risk of dissection extension and vessel occlusion. SCAD patients can have percutaneous coronary intervention (PCI) if they have ongoing ischemia or hemodynamic instability. Coronary artery bypass grafting (CABG) can be an option in cases of failed PCI and high-risk anatomy.

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“…10 In addition, fertility therapy increases the risk of SCAD during pregnancy. 11,12 Evidence of management strategies involving cardiopulmonary bypass (CPB) are based on anecdotal evidence, with even less known on optimal medical management and percutaneous coronary intervention (PCI). 13 Little is known about the optimal combination of medications for treatment of CAD during pregnancy.…”

Section: Cad During Pregnancymentioning

confidence: 99%

“…ART treatment can also lead to fatal peripartum cardiomyopathy in pregnant women 10 . In addition, fertility therapy increases the risk of SCAD during pregnancy 11,12 …”

Section: Cad During Pregnancymentioning

confidence: 99%

Pregnancy and cardiac interventions: What are the optimal management options?

et al. 2020

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Cardiac disease is the leading cause of maternal mortality in the United Kingdom. Major causes of cardiac death in pregnant women include cardiomyopathies, myocardial infarction, ischemic heart disease, and aortic dissection. Uncorrected congenital heart disease and women who have had corrective or palliative surgery may have complicated pregnancies as well. Some women with significant cardiac disease are unable to meet the increased physiological demands of pregnancy. Of these, those who do not respond to medical treatment may require surgical correction such as coronary artery bypass grafting. The risk of cardiac operations for pregnant women is similar to that for nonpregnant women but the fetal mortality rate remains high. Contributing factors to high fetal mortality rates include timing, urgency of operation, and the fetal/fetoplacental response to cardiopulmonary bypass. The aim of this review is to summarize current evidence in utilizing the different management approaches of cardiac issues during pregnancy.

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Multivessel spontaneous coronary artery dissection associated with hormonal infertility therapy in a 39-year-old female

Cited by 11 publications

References 10 publications

Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association

Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association

Spontaneous Coronary Artery Dissection; A Literature Review

Pregnancy and cardiac interventions: What are the optimal management options?

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