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  • Title: [Spontaneous coronary artery dissection can cause acute coronary syndrome. Unusual condition that requires thoughtful management and more research].
    Author: Johnston N, Sarno G, Larsson B, Tornvall P, Varenhorst C.
    Journal: Lakartidningen; 2015 Dec 01; 112():. PubMed ID: 26625103.
    Abstract:
    Spontaneous coronary artery dissection (SCAD) is a non-traumatic and non-iatrogenic injury occurring in the vessel wall caused by either a primary intimal dissection or a primary hematoma in the medial layer. SCAD is more common among women than men and accounts for a small minority of acute coronary syndromes. The causes of SCAD are multifactorial. Peripartum SCAD is most common. Fibromuscular dysplasia has a strong association with SCAD. As spontaneous healing is common in SCAD and PCI is associated with complications an initial conservative approach should always be considered. Medical treatment is based on the underlying cause. Beta blockers are recommended to all patients. The prognosis varies; the highest mortality is reported among women suffering peripartum SCAD. Quality of life is often affected in SCAD patients and accompanied by a high rate of rehospitalizations. More research which focuses on the underlying causes, optimal treatment and rehabilitation is needed.
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