Non-atherosclerotic coronary artery disease associated with sudden cardiac death

Hill, Sharleen F; Sheppard, Mary N.

doi:10.1136/hrt.2009.185157

Cited by 148 publications

(89 citation statements)

References 47 publications

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“…Nonatherosclerotic coronary artery pathology accounts only for 3% of sudden cardiac death caused by myocardial infarction [2]. Nearly half of them are due to congenital anomalies of coronary arteries.…”

Section: Case Reportmentioning

confidence: 99%

“…Most of them are associated with an anomalous origin of coronary arteries. Vasculitis (12%), fibromuscular dysplasia (4%) or acute dissections of coronary arteries (16%) are other rare causes of nonatherosclerotic coronary artery disease [2]. The latter occurs primarily in women during the peripartum period and has a high mortality rate [3].…”

Section: Case Reportmentioning

confidence: 99%

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An uncommon myocardial infarction

2011

Cardiovasc Med

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Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

An uncommon myocardial infarction

2011

Cardiovasc Med

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“…For this reason, patients affected by SCAD could be either completely asymptomatic or present with ACS, cardiogenic shock, cardiac arrest or sudden cardiac death, although this fatal presentation seems to be underestimated [33,34]. Most patients presenting to medical attention manifested typical symptoms of ACS (chest pain, nausea, vomiting, diaphoresis, dyspnea) sometimes accompanied by the increase of cardiac enzymes [35].…”

Section: Clinical Aspectsmentioning

confidence: 99%

How to Approach a Spontaneous Coronary Artery Dissection: An Up-To-Date

Pepe¹,

Cecere²,

Napodano³

et al. 2017

Interv Cardiol J

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AbstarctSpontaneous coronary artery dissection (SCAD) is a separation of the coronary wall layers, not related to trauma, medical procedures or atherosclerosis. The dissection causes the blood entry in the vascular wall with the consequent formation of a false lumen and intramural hematoma (IMH). Two pathogenetic mechanisms have been proposed to explain SCAD: a "primary" rupture of coronary endothelium or the rupture of the "vasa vasorum". Clinical presentation and severity of manifestations are variable, ranging from complete absence of symptoms to acute coronary syndrome (ACS), cardiogenic shock, cardiac arrest or sudden cardiac death. Despite coronary angiography is the first-line examination, by supplying two-dimensional images of the lumen, it does not always allow an incontrovertible diagnosis of SCAD. New intravascular imaging techniques, such as optical coherence tomography (OCT) and intravascular ultrasound (IVUS), have been recently introduced and may be extremely helpful in assessing the coronary wall integrity, thus improving coronary angiography diagnostic accuracy.Because of the lack of large randomized trials comparing different strategies, the optimal treatment of SCAD is still controversial. The first-line approach is conservative and based on medical therapy. Nevertheless, in particular situations an invasive approach is necessary. In the last years, several new strategies have improved the way to perform percutaneous coronary interventions (PCI), such as new generation drug eluting stents (DES), bio-resorbable scaffolds (BRS), sirolimus self-expandable stent (SES), drug eluting balloons (DEB), and cutting balloon. Cardiac artery bypass graft (CABG) is an even more invasive method to restore coronary flow and should be considered in urgent/emergent settings when PCI is not feasible or has failed.Cause the therapeutic approach of SCAD can be substantially different from that of atherosclerotic coronary artery disease, an accurate diagnosis is crucial to set up the best treatment strategy.

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“…SCAD may result from an intimal disruption or "tear" with formation of an intramural hematoma (IMH), or spontaneous intramural bleeding, likely due to the rupture of vasa vasorum (7). SCAD resulting from either mechanism results in blood accumulation within the newly formed false lumen, which may compress the true lumen to varying degrees (1), thus presenting as myocardial ischemia, ACS, cardiogenic shock or sudden cardiac death (4,8,9). SCAD may extensively propagate in anterograde and/or retrograde fashion, with the mean length of dissection typically >45 mm on quantitative coronary angiography (10).…”

Section: Spontaneous Coronary Artery Dissection (Scad) Is Definedmentioning

confidence: 99%