Spontaneous coronary artery dissection: challenges of coronary computed tomography angiography

Mackram F. Eleid, Marysia S. Tweet, Phillip M Young, Eric Williamson, Sharonne Hayes, Rajiv Gulati

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

BACKGROUND: There is limited understanding of the role of cardiac computed tomography angiography (CCTA) for assessment of patients with spontaneous coronary artery dissection (SCAD).

METHODS: In this report we describe the diagnostic utility of CCTA in three young women presenting with signs and symptoms of myocardial ischemia who were eventually diagnosed with SCAD.

RESULTS: None of the women had traditional atherosclerotic risk factors. SCAD was not initially identified on CCTA in any of the three women, but was visualized during retrospective analysis in two patients after invasive coronary angiography. In two patients follow-up CCTA imaging was used successfully for subsequent management.

CONCLUSIONS: In patients presenting with signs or symptoms of acute coronary syndrome, SCAD may be missed or not detectable on CCTA. A negative CCTA should not exclude a diagnosis of SCAD, and invasive coronary angiography should be considered for further evaluation.

Original languageEnglish (US)
Pages (from-to)609-613
Number of pages5
JournalEuropean heart journal. Acute cardiovascular care
Volume7
Issue number7
DOIs
StatePublished - Oct 1 2018

Keywords

  • coronary computed tomography angiography
  • Spontaneous coronary artery dissection

ASJC Scopus subject areas

  • Medicine(all)

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