Publication
Title
Spontaneous coronary artery dissection
Author
Abstract
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome or sudden cardiac death. Initial reports on this condition were scarce as they were based on postmortem examination of fatal cases. Currently, the clinical recognition of SCAD has increased as coronary angiography is utilised frequently in the clinical evaluation of patients with acute coronary syndromes. Moreover, intracoronary imaging techniques such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT), which provide detailed morphological information on coronary lesions and on the location of dissection planes between the different layers of the arterial wall, have enabled a more detailed clinical assessment of SCAD. Furthermore, non-invasive coronary angiography by multidetector computed tomography (MDCT) has been used for longitudinal follow-up evaluation of patients with SCAD. The clinical presentation of SCAD depends on the extent and the flow limiting severity of the coronary dissection, and ranges from asymptomatic to unstable angina, acute myocardial infarction, and ventricular arrhythmias to sudden cardiac death. As several diseases and conditions have been associated with SCAD it therefore probably constitutes a heterogeneous entity. The use of coronary stents represented a breakthrough in the management of iatrogenic coronary dissections occurring during percutaneous interventions. However, in SCAD their application should be balanced against the expected outcome after a spontaneous natural course of this condition, because coronary stenting may end up in a full metallic jacket covering of a long segment of the coronary artery. Current insights into the aetiology, pathogenesis, diagnostic imaging and therapeutic management of SCAD are reviewed.
Language
English
Source (journal)
Heart : official journal of the British Cardiac Society / British Cardiac Society; British Cardiovascular Society [London] - London, 1996, currens
Publication
London : BMJ, 2010
ISSN
1355-6037 [print]
1468-201X [online]
Volume/pages
96:10(2010), p. 801-808
ISI
000277378600016
Full text (Publisher's DOI)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 22.06.2010
Last edited 11.10.2017
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