Key Points
- To synthesize recent advances in the diagnosis, underlying vascular associations, and therapeutic strategies for spontaneous coronary artery dissection.
- Review of prospective patient cohorts and systematically followed registry series evaluating spontaneous coronary artery dissection.
- Assessment of intracoronary imaging modalities for lesion characterization and extra-coronary vascular screening for systemic arteriopathies.
- Intracoronary diagnostic imaging enhances detection of atypical phenotypes such as intramural hematoma, with spontaneous angiographic healing documented in most patients during long-term follow-up.
- Extracoronary screening identifies a high prevalence of concomitant fibromuscular dysplasia in large vascular beds, suggesting a potential shared etiology.
- Observational outcomes favor an initial conservative watchful waiting strategy rather than immediate revascularization for the majority of hemodynamically stable presentations.
Structured PICO
PPopulationPatients with spontaneous coronary artery dissection (SCAD)
This review summarizes recent advances in the understanding of SCAD, emphasizing the role of intracoronary imaging, its association with fibromuscular dysplasia, and the preference for conservative management.