Updates in Spontaneous Coronary Artery Dissection

被引:19
作者
Krittanawong, Chayakrit [1 ,2 ,3 ]
Saw, Jacqueline [4 ]
Olin, Jeffrey W. [3 ]
机构
[1] Baylor Sch Med, Cardiol Sect, 1 Baylor Plaza, Houston, TX 77030 USA
[2] Michael E DeBakey VA Med Ctr, 1 Baylor Plaza, Houston, TX 77030 USA
[3] Mt Sinai Heart, Zena & Michael A Wiener Cardiovasc Inst, Icahn Sch Med Mt Sinai, New York, NY 10029 USA
[4] Vancouver Gen Hosp, Div Cardiol, Vancouver, BC, Canada
基金
美国国家卫生研究院; 加拿大健康研究院;
关键词
Spontaneous coronary artery dissection; SCAD; Recurrent SCAD; SCAD prevention; Cardiac rehabilitation; Coronary revascularization; MYOCARDIAL BLOOD-FLOW; CLINICAL-FEATURES; ASSOCIATION; MANAGEMENT; INFARCTION; PROGNOSIS; ANEURYSM; REVASCULARIZATION; INFLAMMATION; PREVALENCE;
D O I
10.1007/s11886-020-01378-y
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of Review To review the epidemiology, pathogenesis, diagnosis using emerging imaging modalities, management strategy, and prevention of recurrent spontaneous coronary artery dissection (SCAD) and provide a more extensive review of the current data. Recent Findings SCAD generally affects women without conventional cardiovascular risk factors. Diagnosis and management of SCAD are challenging due to heterogeneity, undefined mechanisms, differing phenotypes, and a lack of strong clinical evidence. After reviewing the current evidence to date, we recommend conservative management, including cardiac rehabilitation for SCAD with low-risk features, while coronary revascularization should be considered in SCAD with high-risk features. Non-invasive imaging (e.g., coronary computed tomography angiography, cardiac magnetic resonance, myocardial perfusion imaging) should be considered in diagnosing specific SCAD phenotypes. The standard guideline-based medical therapy for acute coronary syndrome, in the absence of contraindications, should be considered along with appropriate SCAD phenotypes. Discharge counseling and follow-up using emerging imaging modalities should be based on individuals' profiles and approached on a case by case basis.
引用
收藏
页数:11
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