Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association.

Abstract:

:Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction. High rates of recurrent SCAD; its association with female sex, pregnancy, and physical and emotional stress triggers; and concurrent systemic arteriopathies, particularly fibromuscular dysplasia, highlight the differences in clinical characteristics of SCAD compared with atherosclerotic disease. Recent insights into the causes of, clinical course of, treatment options for, outcomes of, and associated conditions of SCAD and the many persistent knowledge gaps are presented.

journal_name

Circulation

journal_title

Circulation

authors

Hayes SN,Kim ESH,Saw J,Adlam D,Arslanian-Engoren C,Economy KE,Ganesh SK,Gulati R,Lindsay ME,Mieres JH,Naderi S,Shah S,Thaler DE,Tweet MS,Wood MJ,American Heart Association Council on Peripheral Vascular Disease; Council on

doi

10.1161/CIR.0000000000000564

subject

Has Abstract

pub_date

2018-05-08 00:00:00

pages

e523-e557

issue

19

eissn

0009-7322

issn

1524-4539

pii

CIR.0000000000000564

journal_volume

137

pub_type

杂志文章,实务指引,评审