Associated vascular lesions in patients with spontaneous coronary artery dissection

Abstract

Abnormalities of the renal arteries were found in 3/12 (25%) of the patients with SCAD. No other vascular abnormalities were identified. Additional diagnostic tests of the renal arteries such as renal artery angiography or duplex sonography may be considered in patients presenting with SCAD.

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

“…69,73 Subsequent cohort studies have shown a varying prevalence of concomitant FMD in extracoronary vascular beds, ranging from 17% to 86%, depending on the patient population, number of imaged vascular beds, and type of imaging used for screening. 6,8,13,29,33,34,74,75 There is also evidence that the prevalence of SCAD is not insignificant in patients with FMD. In the most recent report on dissection and aneurysm in patients with FMD in the US Registry for FMD, of the 237 of 921 patients (25.7%) who experienced ≥1 arterial dissections, 25 patients had SCAD, representing 10.5% of all dissections and an overall prevalence of coronary dissection of 2.7%.…”

“…82 Although FMD is the most common extracoronary vascular abnormality identified among patients with SCAD, patients without imaging signs of FMD have been reported to have other arterial abnormalities, including dissections, aneurysms (including intracranial aneurysms in 14%–23%), or extracoronary and coronary arterial tortuosity (78%). 6,8,13,29,33,74–76,83 Some of these patients may indeed have had FMD but it was not identified because of incomplete or insufficiently sensitive imaging.…”

Recent Developments in the Understanding and Management of Fibromuscular Dysplasia

“…33 Two patients had multifocal FMD and 1 patient had a spontaneous renal artery dissection. However, patients in this series underwent magnetic resonance angiography (MRA) imaging, which has decreased sensitivity for diagnosis of mild FMD lesions compared with catheter‐based angiography.…”

What Clinicians Should Know Αbout Spontaneous Coronary Artery Dissection

“…The presence of extracoronary vascular abnormalities (EVAs) in patients with SCAD, especially fibromuscular dysplasia (FMD), is significant with prevalence rates of 25% to 86%. 1,[18][19][20] In a series of 115 Mayo Clinic SCAD Clinic outpatients who underwent comprehensive imaging, 66% had detectable EVAs (FMD, aneurysms, dissection, and aortic tortuosity) with wide anatomical distribution, including the abdomen (36%), pelvis (28%), and neck (27%). The most common EVA was FMD (45%).…”