Spontaneous coronary artery dissection: one entity with several therapeutic options

Wain-Hobson, Julien; Roule, Vincent; Dahdouh, Ziad; Sabatier, Rémi; Lognoné, Thérèse; Grollier, Gilles

doi:10.1016/j.carrev.2012.02.001

Cited by 15 publications

(18 citation statements)

References 7 publications

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“…Exclusion of duplicate results and articles not meeting specified a priori criteria (162 articles) resulted in 111 articles describing 138 cases of P-SCAD [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40], [41], [42], [43], [44], [45], [46], [47], [48], [49], [50], [51], [52], [53], [54], [55], [56], [57], [58], [59], [60], [61], [62], [63], [64], [65], [66], [67], [68], [69], [70], [71], [72], [73], [74], [75], [76], [77], [78], [79], [80], [81], [82], [83], [84], [85], [86], [87], [88], [89], …”

Section: Methodsmentioning

confidence: 99%

Evolving management and improving outcomes of pregnancy-associated spontaneous coronary artery dissection (P-SCAD): a systematic review

Paratz

Kao

MacIsaac

et al. 2018

IJC Heart & Vasculature

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BackgroundPregnancy-associated spontaneous coronary artery dissection (P-SCAD) is defined as SCAD occurring during pregnancy or within 3 months post-partum. Earlier systematic reviews have suggested a high maternal and foetal mortality rate. We undertook a structured systematic review of P-SCAD demographics, management and maternal and foetal outcomes.MethodsCase study identification was conducted according to PRISMA guidelines, with screening of all published P-SCAD cases not meeting pre-defined exclusion criteria. Of two hundred and seventy-three publications screened, one hundred and thirty-eight cases met inclusion criteria. Cases were allocated to one of three time periods; 1960–85 (twenty cases) reflecting early management of P-SCAD, 1986–2005 (forty-two cases) reflecting recent management, and 2006–16 (seventy-six cases), reflecting contemporary management.ResultsThe only significant demographic change in women experiencing P-SCAD over the last 50 years was an increasing proportion of primigravidas (p = 0.02). Management and outcomes, however, have altered significantly. Emergent angiography (p < 0.0001), reduced thrombolysis (p = 0.006) and increasingly conservative or percutaneous management (p < 0.0001) are associated with dramatic reductions in maternal mortality (85% in earliest reports to 4% in the last decade, p < 0.0001) and foetal mortality (50% in earliest reports to 0.0% in the last decade, p = 0.023).ConclusionThis systematic review of temporal changes in presentation, management and outcomes of P-SCAD represents the widest range of variables analysed in the largest cohort of P-SCAD patients to date. In the setting of earlier coronary angiography and increasingly conservative management, maternal and foetal survival rates continue to improve.

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Section: Methodsmentioning

confidence: 99%

Evolving management and improving outcomes of pregnancy-associated spontaneous coronary artery dissection (P-SCAD): a systematic review

Paratz

Kao

MacIsaac

et al. 2018

IJC Heart & Vasculature

View full text Add to dashboard Cite

show abstract

“…The two proposed mechanisms in the pathogenesis of SCAD include the spontaneous rupture of vasa vasorum resulting in intramural haematoma and intimal or medial tear which is usually complicated with a superimposed thrombus 9. Therefore, the initial management of patients with SCAD admitting with unstable angina and acute coronary syndrome is critical.…”

Section: Discussionmentioning

confidence: 99%

“…Emergent coronary angiography in patients with SCAD should be performed with great caution, since aggressive intubation of the coronary ostium and contrast injection may lead extension of dissection 9. We did not prolong the catheterisation process after we had seen the dissection flap beginning from LMCA to LAD, provided that Cx and RCA branches are free of dissection or critical stenosis.…”

Section: Discussionmentioning

confidence: 99%

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Beating heart myocardial revascularisation of a sudden cardiac death survivor with spontaneous coronary artery dissection: pitfalls from diagnosis to surgery

Çetin

Özyüksel

2014

BMJ Case Reports

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SUMMARYSpontaneous coronary artery dissection is a rare clinical condition with a wide range of clinical presentations ranging from asymptomatic cases to life-threatening ventricular arrhythmias and sudden cardiac death. The exact pathophysiological mechanism has not been fully established yet. We would like to present a survivor of sudden cardiac death presenting with ventricular fibrillation due to spontaneous coronary artery dissection. The prompt evaluation, medical management, surgical myocardial revascularisation and value of offpump coronary artery bypass surgery are discussed. BACKGROUND

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“…In addition to peripartum patients, there are other predisposing conditions for SCAD such as Marfan syndrome,2 Ehlers-Danlos syndrome,3 fibromuscular dysplasia,4 vasculitis,5 exercise,6–8 oral contraceptives,9 cocaine use,10 chest wall trauma,11 prolonged sneezing12 and atherosclerotic coronary disease 13. Thus, functional or structural vessel wall abnormalities have been suggested in causes for SCAD, but to the best of our knowledge there have been no reports describing SCAD in patients with sepsis.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous coronary artery dissection in a patient with bacterial meningitis

et al. 2013

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SUMMARYA 40-year-old man was admitted to our hospital because of the acute onset of fever and headache, which were attributed to bacterial meningitis. Antibiotic treatment was initiated and his condition gradually improved. On day 5 after admission, immediately after masturbation, he developed abrupt onset of severe chest pain and cold sweat and the ECG suggested acute anterior myocardial infarction. Immediate coronary angiography revealed spontaneous dissection of the left anterior descending artery. After conservative management, his cardiac function improved. Acute coronary syndrome may be rarely caused by spontaneous coronary artery dissection. Sepsis was considered as a probable trigger for spontaneous coronary artery dissection, possibly through vascular damage from increased nitric oxide and sympathetic nervous over-activation. BACKGROUND

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Spontaneous coronary artery dissection: one entity with several therapeutic options

Cited by 15 publications

References 7 publications

Evolving management and improving outcomes of pregnancy-associated spontaneous coronary artery dissection (P-SCAD): a systematic review

Evolving management and improving outcomes of pregnancy-associated spontaneous coronary artery dissection (P-SCAD): a systematic review

Beating heart myocardial revascularisation of a sudden cardiac death survivor with spontaneous coronary artery dissection: pitfalls from diagnosis to surgery

Spontaneous coronary artery dissection in a patient with bacterial meningitis

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