Incidence, Clinical Presentation, and Causes of 30-Day Readmission Following Hospitalization With Spontaneous Coronary Artery Dissection

Gad, Mohamed M.; Mahmoud, Ahmed N.; Saad, Anas M.; Bazarbashi, Najdat; Ahuja, Keerat Rai; Karrthik, Antonette; Elgendy, Islam Y.; Elgendy, Akram Y.; Don, Creighton W.; Hira, Ravi S.; Massoomi, Michael; Saw, Jacqueline; Anderson, R. David; Kapadia, Samir

doi:10.1016/j.jcin.2019.12.033

Cited by 53 publications

(35 citation statements)

References 23 publications

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“…Among the SCAD readmissions, 50.6% of patients were readmitted in the first-week postdischarge, with 54.5% of AMI readmissions occurring in the first 2 days post-discharge. Unfortunately, there is no specific data reported about the incidence of LV thrombus after SCAD-MI [12].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous coronary artery dissection associated with incidental finding of left ventricular thrombus

Santana

Guragai

Patel

et al. 2021

Journal of Community Hospital Internal Medicine Perspectives

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Spontaneous Coronary Artery Dissection (SCAD) is one of the nonatherosclerotic causes of Acute Coronary Syndrome. It's extremely rare for SCAD to present in an asymptomatic male, with incidental finding of Left Ventricular (LV) thrombus on echocardiogram. This report presents the case of a 36-year-old male with such an atypical presentation of Spontaneous Coronary Artery Dissection with Left Ventricular apical thrombus as a complication. The patient received successful medical management, with excellent clinical outcomes. This case highlights the importance of an early recognition and treatment strategy for both conditions using medical therapy.

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Section: Discussionmentioning

confidence: 99%

Spontaneous coronary artery dissection associated with incidental finding of left ventricular thrombus

Santana

Guragai

Patel

et al. 2021

Journal of Community Hospital Internal Medicine Perspectives

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“…Presence of tortuosity and lack of intraluminal thrombus helps to differentiate it from dissection resulting from rupture of atherosclerotic plaque [6]. Chest pain after SCAD is not infrequent and may be either recurrent or may persist for weeks often leading to frequent hospitalization [7]. Mental stress, exertion, and perimenopausal state are few of the triggers.…”

Section: Discussionmentioning

confidence: 99%

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2021

Int J Clin Cardiol

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Spontaneous coronary artery dissection (SCAD) is a rare but an important cause of ST elevation myocardial infarction (STE-MI) in young patients. Here, we report case of a 32-year-old male presenting as acute anterior wall STEMI for which was thrombolysed. Coronary angiogram revealed spiral luminal filling defects with extensive contrast staining of proximal left anterior descending artery involving diagonal branch representing Type D dissection. As patient refused any intervention, he was managed conservatively. He presented with unstable angina 6-weeks later. Repeat angiogram revealed complete healing of dissection along with borderline lesion. As his treadmill test was negative for exercise induced myocardial ischaemia, he was managed conservatively. This case highlights that beside intervention, patients with high grade dissection may respond to conservative management.

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“…Of the approximately 20% of patients with SCAD who are readmitted within 30 days of the index event, many develop chronic nitrate-responsive chest pain. 3 This is suspected to be related to coronary microvascular dysfunction, which is common in this population. In a small study of 17 patients undergoing coronary fl ow reserve testing on coronary angiography at least 3 months post-SCAD, more than 70% had coronary microvascular dysfunction defi ned by a coronary fl ow reserve < 2.5 or an index of microcirculatory resistance > 25 units.…”

Section: Monitor For Chest Pain and Recurrencementioning

confidence: 95%

“…lifting. 2 Studies suggest that SCAD accounts for 1% to 4% of cases of ACS overall, 3 15% to 20% of peripartum ACS cases, 2 and up to 35% of ACS in women under age 60. 4,5 A number of conditions have been associated with SCAD, most notably fi bromuscular dysplasia, and less commonly chronic systemic infl ammatory disease, connective-tissue disorders, pregnancy, and hypothyroidism.…”

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confidence: 99%