Why the study?
What is the prevalence of associated vascular lesions in patients with spontaneous coronary artery dissection?
What is the prevalence of associated vascular lesions in patients with spontaneous coronary artery dissection?
In patients with spontaneous coronary artery dissection, screening for associated vascular lesions such as fibromuscular dysplasia using MR angiography or duplex sonography reveals renal artery abnormalities in 25% of cases.
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May support considering vascular screening in SCAD; hypothesis-generating from small case series and requires validation before practice change.
AIM: To identify vascular abnormalities in patients presenting with spontaneous coronary artery dissection (SCAD). METHODS: We performed a whole-body MR angiography and a duplex sonography of the renal and carotid arteries in 12 patients (9 women, 3 men) with SCAD to identify vascular abnormalities. RESULTS: MR angiography revealed abnormalities of the renal arteries in 3/12 patients (25%). All 3 patients were women, 2 presented with changes suggesting fibromuscular dysplasia (FMD), 1 had a spontaneous renal artery dissection. No other vascular abnormalities were identified in any of the patients. Duplex sonography confirmed MR findings and showed non-significant renal artery stenoses in both patients with FMD. CONCLUSIONS: Abnormalities of the renal arteries were found in 3/12 (25%) of the patients with SCAD. No other vascular abnormalities were identified. Additional diagnostic tests of the renal arteries such as renal artery angiography or duplex sonography may be considered in patients presenting with SCAD.
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Toggweiler et al. (2012) studied this question.
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