Key result
Spontaneous coronary artery dissection represents up to 25% of acute coronary syndromes in women aged 40 to 65 years and is predominantly managed with conservative treatment in stable patients.
Why the study?
SCAD incidence is likely underestimated and more clinical awareness is needed regarding its predisposing factors, precipitating stressors, optimal treatment, and prognosis.
This review highlights that SCAD is a significant, often underdiagnosed cause of ACS in young to middle-aged women, requiring a high index of suspicion and generally favoring a conservative management approach in stable patients.
Supports SCAD evaluation in women aged 40-65 with ACS; leaves open need for prospective trials on management.
Spontaneous coronary artery dissection (SCAD) represents around 25% of cases of acute coronary syndromes (ACS) in women aged 40-65 years who have few or no traditional cardiovascular risk factors. It is assumed that the incidence is underestimated, as the angiographic appearance of SCAD may often mimic atherosclerosis. This review aims to examine SCAD by focusing on the associated predisposing factors and precipitating stressors in this heterogeneous patient population, as well as the best treatment approach and the prognosis. Progressive knowledge has improved our current understanding of SCAD, but more awareness among clinicians is necessary. Recently, two position papers from the European Society of Cardiology (ESC) and the American Heart Association (AHA) have been released, which will be summarised in brief.
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Janssen et al. (2019) conducted a review in Spontaneous coronary artery dissection (SCAD). Spontaneous coronary artery dissection represents up to 25% of acute coronary syndromes in women aged 40 to 65 years and is predominantly managed with conservative treatment in stable patients.
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