Canadian Journal of Cardiology
Editorial| Volume 37, ISSUE 11, P1695-1698, November 2021

Spontaneous Coronary Artery Dissection and Fibromuscular Dysplasia: Chicken or Egg? Which Comes First?

Published:September 23, 2021DOI:
      Spontaneous coronary artery dissection (SCAD) has become increasingly recognized over the last few years as a nonatherosclerotic cause of acute coronary syndrome and potential sudden cardiac death. It occurs most commonly in women aged ≤ 50 years and, at an estimated prevalence of 1% to 4% of all acute coronary syndromes, is likely underdiagnosed. SCAD is associated with obstruction to coronary blood flow due to an intramural hematoma caused by an intimal tear. Accurate diagnosis of SCAD at the time of initial coronary angiography is key to appropriate management, unless there is high-risk anatomy (left main or severe proximal multivessel involvement) or hemodynamic compromise. Conservative management is recommended, as invasive therapies have been associated with increased complications and low rates of success.
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