Multivessel Spontaneous Coronary Artery Dissection With Cardiogenic Shock: A Systematic Review

Spontaneous coronary artery dissections (SCAD) are characterized by tears of nonatherosclerotic etiology within coronary vessels. This clinical entity promotes intravascular hematoma formation, which can compress the arterial lumen and obstruct coronary blood flow. Subsequent limitations in coronary perfusion facilitate an environment within the myocardium conducive to acute coronary syndrome and cardiogenic shock from relative hemodynamic perturbation. Although SCAD has been reported in the literature, there is a dearth of literature reporting the management of multivessel SCAD, with no official guidelines available for reference. We present a systematic review of the clinical management of multivessel SCAD within the context of subsequent cardiogenic shock in hopes of generating a dialogue to reach cogent approaches to minimize morbidity and mortality in multivessel SCAD management.