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Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary revascularization Improving the Design of Future PCI Trials for Stable Coronary Artery Disease: JACC State-of-the-Art Review Mortality 10 Years After Percutaneous or Surgical Revascularization in Patients With Total Coronary Artery Occlusions Generalizing Intensive Blood Pressure Treatment to Adults With Diabetes Mellitus Effect of a Home-Based Wearable Continuous ECG Monitoring Patch on Detection of Undiagnosed Atrial Fibrillation The mSToPS Randomized Clinical Trial Mortality Differences Associated With Treatment Responses in CANTOS and FOURIER: Insights and Implications Efficacy and safety of rosuvastatin vs. atorvastatin in lowering LDL cholesterol : A meta-analysis of trials with East Asian populations Digital learning and the future cardiologist Incidence of contrast-induced acute kidney injury in a large cohort of all-comers undergoing percutaneous coronary intervention: Comparison of five contrast media 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)

Review ArticleVolume 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. 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.