CCTA missed the diagnosis of spontaneous coronary artery dissection in all three women, highlighting the need for further evaluation with invasive coronary angiography.
Does cardiac computed tomography angiography (CCTA) accurately identify spontaneous coronary artery dissection (SCAD) in young women presenting with myocardial ischemia?
CCTA may miss spontaneous coronary artery dissection in patients presenting with acute coronary syndrome, indicating that a negative CCTA should not exclude SCAD and invasive angiography should be considered.
Absolute Event Rate: 0% vs 0%
Background: There is limited understanding of the role of cardiac computed tomography angiography (CCTA) for assessment of patients with spontaneous coronary artery dissection (SCAD). Methods: In this report we describe the diagnostic utility of CCTA in three young women presenting with signs and symptoms of myocardial ischemia who were eventually diagnosed with SCAD. Results: None of the women had traditional atherosclerotic risk factors. SCAD was not initially identified on CCTA in any of the three women, but was visualized during retrospective analysis in two patients after invasive coronary angiography. In two patients follow-up CCTA imaging was used successfully for subsequent management. Conclusions: In patients presenting with signs or symptoms of acute coronary syndrome, SCAD may be missed or not detectable on CCTA. A negative CCTA should not exclude a diagnosis of SCAD, and invasive coronary angiography should be considered for further evaluation.
Eleid et al. (Tue,) reported a other. CCTA missed the diagnosis of spontaneous coronary artery dissection in all three women, highlighting the need for further evaluation with invasive coronary angiography.