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Spontaneous Coronary Artery Dissection: JACC State-of-the-Art Review Impact of Chronic Total Coronary Occlusion Location on Long-term Survival After Percutaneous Coronary Intervention Late Survival Benefit of Percutaneous Coronary Intervention Compared With Medical Therapy in Patients With Coronary Chronic Total Occlusion: A 10-Year Follow-Up Study Radial Versus Femoral Access for Coronary Interventions Across the Entire Spectrum of Patients With Coronary Artery Disease: A Meta-Analysis of Randomized Trials Impact of age and comorbidity on risk stratification in idiopathic pulmonary arterial hypertension Everolimus-Eluting Bioresorbable Scaffolds Versus Everolimus-Eluting Metallic Stents Prospective Elimination of Distal Coronary Sinus to Left Atrial Connection for Atrial Fibrillation Ablation (PRECAF) Randomized Controlled Trial Prognostic Value of the Residual SYNTAX Score After Functionally Complete Revascularization in ACS Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes Impact of Off-Hours Versus On-Hours Primary Percutaneous Coronary Intervention on Myocardial Damage and Clinical Outcomes in ST-Segment Elevation Myocardial Infarction
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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.
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