Spontaneous coronary artery dissection (SCAD): A contemporary review

Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction that most frequently affects younger women, making it an important cause of morbidity and mortality within these demographics. The evolution of intracoronary imaging, improved diagnosis with coronary angiography, and ongoing research efforts and attention via social media, has led to increasing recognition of this previously underdiagnosed condition. In this review, we provide a summary of the current body of knowledge, as well as focused updates on the pathogenesis of SCAD, insights on genetic susceptibility, contemporary diagnostic tools, and immediate, short- and long-term management. Spontaneous Coronary Artery Dissection (SCAD) is an increasingly recognized cause of myocardial infarction that most frequently affects younger women, making it an important cause of morbidity and mortality within these demographics. The evolution of intracoronary imaging (C - OCT image of IMH), improved diagnosis with coronary angiography (B - Type 2 A SCAD in an obtuse marginal artery), and ongoing research efforts and attention via social media, has led to increasing recognition of this previously underdiagnosed condition (A - IMH as the important pathophysiologic mechanism in SCAD).OCT, optical coherence tomography; IMH, intramural hematoma; SCAD, Spontaneous Coronary Artery Dissection. image