Sudden Cardiac Death in Patients With Spontaneous Coronary Artery Dissection

Sk, Sharma; Rozen, Guy; Duran, Jessica; Mela, Theofanie; Wood, Malissa J.

doi:10.1016/j.jacc.2017.05.010

Cited by 31 publications

(33 citation statements)

References 3 publications

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“…Patients with SCAD have been reported to receive early implantation of cardioverter-defibrillators or more aggressive management despite the absence of high-risk features such as recurrent arrhythmia, LV dysfunction, or persistent ischemia. 188 There are potential harms with this unproven aggressive practice, and currently, there is insufficient evidence to suggest altering clinical decision making for implantation of cardioverter-defibrillators on the basis of the cause of the ischemic event. 172,189 …”

Section: Early Scad Outcomes: Implications For Duration Of Hospitalizmentioning

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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842

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: Early Scad Outcomes: Implications For Duration Of Hospitalizmentioning

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

842

1,344

View full text Add to dashboard Cite

show abstract

“…SCAD shares several features with takotsubo syndrome, as ACS presentation, preponderance of female gender, presence of triggers and prompt recovery of coronary and contractile function (not all SCAD cases) 36 58 59. Therefore, it is important to bear in mind these two entities in the differential diagnosis.…”

Section: Patient Profilementioning

confidence: 99%

“…Ventricular function should be monitored during hospitalisation and later after discharge since left ventricular systolic impairment at baseline has shown to improve significantly in the short term 58. This has implications for tailoring medical treatment and, especially, for appropriately indicating primary prevention of sudden cardiac death in those patients with severe ventricular disfunction 59. If left ventricular function is severely depressed, until reassessment, the role of wearable defibrillators for this relatively young population is appealing.…”

Section: Convalescence Managementmentioning

confidence: 99%

Spontaneous coronary artery dissection: contemporary aspects of diagnosis and patient management

et al. 2018

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Spontaneous coronary artery dissection is an increasingly recognised cause of acute coronary syndromes, especially in young and middle-age women. Recognising its particularities and differences with atherosclerotic disease is central for appropriately identifying and approaching these patients. The authors review the current state of knowledge on spontaneous coronary artery dissection and provide practical recommendations for the diagnosis and management of this condition, both in the acute and convalescence phases.

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“…Coronary angiography is the primarily imaging modality for diagnosing SCAD [4]. Medical management and conservative therapy for SCAD typically results in favorable outcomes [5], but there is a high recurrence rate of major cardiovascular events with the majority being SCAD [2,6]. Major adverse cardiovascular events (MACE) can range from recurrent MI, recurrent SCAD, unanticipated revascularization, congestive heart age of 64, again with substernal chest pain.…”

Section: Introductionmentioning

confidence: 99%

Recurrent Spontaneous Coronary Artery Dissection Leading to Recurrent Sudden Cardiac Arrests: Who is at Risk?

Weber¹,

Elliott²,

Gopalakrishnan³

2020

Int J Clin Cardiol

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Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS) with medical management and conservative therapies usually resulting in favorable outcomes. SCAD often is recurrent, especially in high risk individuals with underlying connective tissue disorders. Lethal ventricular arrhythmias have been reported in SCAD without clear indications for secondary prevention with implantable cardiovert-defibrillator (ICD). Depending on risk factor for recurrence as well as susceptibility towards ventricular arrhythmias some patients may benefit from early implantations of ICDs.

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Sudden Cardiac Death in Patients With Spontaneous Coronary Artery Dissection

Cited by 31 publications

References 3 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: contemporary aspects of diagnosis and patient management

Recurrent Spontaneous Coronary Artery Dissection Leading to Recurrent Sudden Cardiac Arrests: Who is at Risk?

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