Spontaneous Coronary Artery Dissection: Once is Never Enough

Majeed, Kamran; Glenie, Timothy

doi:10.1016/j.hlc.2014.11.007

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…It is not clear the advantage of drug-eluting stents has over bare metal stent in SCAD, but it does have a lower risk of stent restenosis. Percutaneous coronary revascularization with drug-eluting stents does carry its own complication: 1) expansion of hemorrhage and hematoma requiring stenting of large lengths of artery, and 2) guidewire insertion into false lumen propagating the dissection [23,25].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Coronary Artery Dissection Masquerading as Coronary Artery Stenosis in a Young Patient

et al. 2019

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Patient: Male, 34Final Diagnosis: Spontaneous coronary artery dissectionSymptoms: Chest painMedication: —Clinical Procedure: —Specialty: CardiologyObjective:Rare diseaseBackground:Spontaneous coronary artery dissection (SCAD) is primarily found in females. SCAD can have many precipitating factors such as exercise, trauma, pregnancy, drugs, and connective tissue disease. Prognosis is poor for left main stem, left anterior descending (LAD) artery, and multivessel involvement, especially for females.Case Report:We present a case of young African American male with sickle cell disease who presented with chest pain associated with shortness of breath. He was found to have non-ST elevation myocardial infarction (NSTEMI). He was diagnosed with SCAD during catheterization with the help of intravascular ultrasound imaging. Three drug-eluting stents were placed to cover the proximal LAD vessel along its whole length until resolution of the lesion. The patients’ hospital course was complicated by an additional finding of left ventricular thrombus, possibly a complication of NSTEMI, which was treated with anticoagulation to complete resolution.Conclusions:SCAD is fatal, it can proceed to cause myocardial infarction as in this particular patient’s case, and sudden death if not recognized early. It can be missed on angiography alone; further intracoronary imaging such as intravascular ultrasound and optical computed tomography should be used to confirm the diagnosis of SCAD so that early and appropriate treatment can ensue.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Coronary Artery Dissection Masquerading as Coronary Artery Stenosis in a Young Patient

et al. 2019

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“…As a result, surgical grafting to the true lumen may also confront special difficulties [16]. Limited data suggest favorable outcome of SCAD after initial treatment, with low recurrent rates of 5-10% [17][18][19][20], although PCI failure can be relatively high, in comparison with ACS due to common atherosclerotic coronary artery disease. Conservative management in SCAD cases with preserved vessel flow without ongoing ischemia, may have similar outcome with revascularization, giving a reliable alternative in such cases [19].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Coronary Artery Dissection: Presentation of Three Cases and Short Review of the Literature

Chalaris¹

2015

Emerg Med (Los Angel)

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“…4 While SCAD has been somewhat clarified, the features, presentation, and intravascular imaging of recurrent spontaneous dissections have not been assessed, except in peripartum patients. 5 Our study aimed to analyze the clinical characteristics, presentation, and treatment of patients with recurrent SCAD.…”

Section: Introductionmentioning

confidence: 99%

Characterization of single vs. recurrent spontaneous coronary artery dissection

Rigatelli

Dell’Avvocata

Picariello

et al. 2018

Asian Cardiovasc Thorac Ann

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Background Spontaneous coronary artery dissection is a rare non-atherosclerotic cause of acute coronary syndromes, often underdiagnosed based on standard coronary angiography. Moreover, features, presentation, and intravascular imaging of recurrent spontaneous dissections have not been assessed. Methods Patients with recurrent spontaneous coronary artery dissection, who were admitted to our catheterization laboratory over a 10-year period, were identified. Demographic, clinical, angiographic, and intravascular imaging data were reviewed and analyzed, comparing patients with a single event with those who had a recurrence. Results Over the study period, 31 (0.2%, mean age 48.1 ± 8.8 years, 24 females) of 10,954 patients who underwent coronary angiography experienced a single spontaneous coronary artery dissection, and 6 (0.05%, mean age 49.3 ± 10.1 years, 4 females) experienced recurrent spontaneous coronary artery dissection. No patient suffered more than 2 dissections. Arterial hypertension ( p = 0.004), a string sign measuring >15 mm on angiography, and hematoma on intravascular ultrasound imaging were more frequently observed in patients with recurrent spontaneous coronary artery dissection. Conclusions Hypertension, length of the string sign on angiography, and hematoma on intravascular ultrasound imaging might identify patients at higher risk of recurrent spontaneous coronary artery dissection despite a lifelong dual antiplatelet regimen.

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Spontaneous Coronary Artery Dissection: Once is Never Enough

Cited by 3 publications

References 11 publications

Spontaneous Coronary Artery Dissection Masquerading as Coronary Artery Stenosis in a Young Patient

Spontaneous Coronary Artery Dissection Masquerading as Coronary Artery Stenosis in a Young Patient

Spontaneous Coronary Artery Dissection: Presentation of Three Cases and Short Review of the Literature

Characterization of single vs. recurrent spontaneous coronary artery dissection

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