TCT-9 Spontaneous Coronary Artery Dissection: Association with Predisposing Arteriopathies and Precipitating Stressors, and Cardiovascular Outcomes

Spontaneous Coronary Artery Dissection Misdiagnosed as Takotsubo Cardiomyopathy: A Case Series

“…Demographics and clinical presentation of the 9 patients in the case series weeks of presentation. 4 Such rapid spontaneous arterial healing likely accounts for the reversibility of the wall motion abnormality. Hence, these 2 clinical entities have several clinical similarities, including presentation with MI, association with precipitating stressors, and reversal of wall motion abnormalities.…”

“…In our series, w60% of patients with SCAD had associated stressors that were emotional, physical (eg, isometric exercises, aerobic exercises, violent retching/vomiting/coughing, or related to drugs [eg, cocaine, amphetamines]). 4 Regarding the reversibility of wall motion abnormality, SCAD can result in prolonged ischemia in the territory of the dissected artery, which can cause myocardial stunning of the corresponding territory that can normalize when the artery spontaneously heals. As we have shown, the natural history of most conservatively managed dissected coronary arteries is that they heal spontaneously, supporting our theory that myocardial stunning is responsible for the corresponding transient wall motion abnormality in these SCAD cases.…”

Spontaneous Coronary Artery Dissection Associated With Ascending Aortic Dystrophy: A Tear for Fear

“…1 This case illustrates the rare association of SCAD and aortic root dystrophy in some patients, 2 suggesting a common underlying diffuse intrinsic vascular disease as a potential link between the 2 entities. Hence, cystic medial necrosis (which includes focal fragmentation of elastic fibers, loss of smooth muscle cells of media, associated accumulation of myxoid material replacing smooth muscle, and varying deposits of mucopolysaccharides) has been reported as a potential cause of SCAD and is also acknowledged as a main underlying cause of thoracic aortic aneurysm.…”

Optical Coherence Tomography in the Diagnosis and Management of Spontaneous Coronary Artery Dissection

“…11 In this cohort, 92% of patients were female (62% of whom were postmenopausal) and the mean age was 52. The dominant angiographic appearance of SCAD was again that of a smooth diffuse narrowing (type 2 angiographic SCAD), observed in 67% of cases.…”

“…[9][10][11] In a retrospective singlecenter cohort study from the Mayo clinic, 10 87 angiographically confirmed cases of SCAD were identified. Among those with angiographically confirmed SCAD, 82% were female and the mean age was 43 years.…”