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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Article info
Publication history
Published online: September 23, 2021
Accepted:
September 14,
2021
Received:
August 17,
2021
Footnotes
See article by Inohara et al.,pages 1725–1732of this issue.
See page 1698 for disclosure information.
Identification
Copyright
© 2021 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
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- Coronary Angiographic Manifestations and Outcomes in Spontaneous Coronary Artery Dissection Patients With and Without Fibromuscular DysplasiaCanadian Journal of CardiologyVol. 37Issue 11
