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Review Article

Volume 76, Issue 8, August 2020

JOURNAL：J Am Coll Cardiol.

Article Link

Spontaneous Coronary Artery Dissection: JACC State-of-the-Art Review

SN Hayes, MS Tweet, D Adlam et al.

5144

Keywords: fibromuscular dysplasia; genetics; myocardial infarction; pregnancy-associated SCAD; women

ABSTRACT

Over the past decade, spontaneous coronary artery dissection (SCAD) has emerged as an important cause of myocardial infarction, particularly among younger women. The pace of knowledge acquisition has been rapid, but ongoing challenges include accurately diagnosing SCAD and improving outcomes. Many SCAD patients experience substantial post-SCAD symptoms, recurrent SCAD, and psychosocial distress. Considerable uncertainty remains about optimal management of associated conditions, risk stratification and prevention of complications, recommendations for physical activity, reproductive planning, and the role of genetic evaluations. This review provides a clinical update on the diagnosis and management of patients with SCAD, including pregnancy-associated SCAD and pregnancy after SCAD, and highlight high-priority knowledge gaps that must be addressed.