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

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 awa...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) Vol. 137; no. 19; p. e523
Main Authors: Hayes, Sharonne N, Kim, Esther S H, Saw, Jacqueline, Adlam, David, Arslanian-Engoren, Cynthia, Economy, Katherine E, Ganesh, Santhi K, Gulati, Rajiv, Lindsay, Mark E, Mieres, Jennifer H, Naderi, Sahar, Shah, Svati, Thaler, David E, Tweet, Marysia S, Wood, Malissa J
Format: Journal Article
Language:English
Published: United States 08.05.2018
Subjects:
American Heart Association
Cardiac Imaging Techniques - standards
Cardiovascular Agents - therapeutic use
Consensus
Conservative Treatment - standards
Coronary Artery Bypass - standards
Coronary Vessel Anomalies - diagnostic imaging
Coronary Vessel Anomalies - mortality
Coronary Vessel Anomalies - therapy
Female
Humans
Male
Middle Aged
Percutaneous Coronary Intervention - standards
Predictive Value of Tests
Pregnancy
Prevalence
Risk Assessment
Risk Factors
Treatment Outcome
United States
Vascular Diseases - congenital
Vascular Diseases - diagnostic imaging
Vascular Diseases - mortality
Vascular Diseases - therapy
United States
coronary artery dissection, spontaneous
fibromuscular dysplasia
myocardial infarction
AHA Scientific Statements
women
ISSN:1524-4539, 1524-4539
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Summary: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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ISSN:1524-4539
1524-4539
DOI:10.1161/CIR.0000000000000564