TY - JOUR
T1 - Spontaneous coronary artery dissection
T2 - Current state of the science: A scientific statement from the American Heart Association
AU - Hayes, Sharonne N.
AU - Kim, Chair Esther S.H.
AU - Saw, Jacqueline
AU - Adlam, David
AU - Arslanian-Engoren, Cynthia
AU - Economy, Katherine E.
AU - Ganesh, Santhi K.
AU - Gulati, Rajiv
AU - Lindsay, Mark E.
AU - Mieres, Jennifer H.
AU - Naderi, Sahar
AU - Shah, Svati
AU - Thaler, David E.
AU - Tweet, Marysia S.
AU - Wood, Malissa J.
N1 - Publisher Copyright:
© 2018 American Heart Association, Inc.
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
KW - AHA Scientific Statements
KW - Coronary artery dissection spontaneous
KW - Fibromuscular dysplasia
KW - Myocardial infarction
KW - Women
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U2 - 10.1161/CIR.0000000000000564
DO - 10.1161/CIR.0000000000000564
M3 - Article
C2 - 29472380
AN - SCOPUS:85043516435
SN - 0009-7322
VL - 137
SP - e523-e557
JO - Circulation
JF - Circulation
IS - 19
ER -