Spontaneous coronary artery dissection other imaging findings: Difference between revisions
Arzu Kalayci (talk | contribs) No edit summary |
Arzu Kalayci (talk | contribs) No edit summary |
||
Line 12: | Line 12: | ||
=== Intravascular Ultrasound and Optical Coherence Tomogrpahy === | === Intravascular Ultrasound and Optical Coherence Tomogrpahy === | ||
In the event that diagnosis of SCAD based on angiography is ambiguous, [[intravascular ultrasound]] ([[IVUS]])<ref name="pmid11835932">{{cite journal |author=Maehara A, Mintz GS, Castagna MT, ''et al.'' |title=Intravascular ultrasound assessment of spontaneous coronary artery dissection |journal=[[The American Journal of Cardiology]] |volume=89 |issue=4 |pages=466–8 |year=2002 |month=February |pmid=11835932 |doi= |url=}}</ref><ref name="pmid14760197">{{cite journal |author=Porto I, Banning AP |title=Intravascular ultrasound imaging in the diagnosis and treatment of spontaneous coronary dissection with drug-eluting stents |journal=[[The Journal of Invasive Cardiology]] |volume=16 |issue=2 |pages=78–80 |year=2004 |month=February |pmid=14760197 |doi= |url=}}</ref><ref name="pmid18513437">{{cite journal |author=Arnold JR, West NE, van Gaal WJ, Karamitsos TD, Banning AP |title=The role of intravascular ultrasound in the management of spontaneous coronary artery dissection |journal=[[Cardiovascular Ultrasound]] |volume=6 |issue= |pages=24 |year=2008 |pmid=18513437 |pmc=2429898 |doi=10.1186/1476-7120-6-24 |url=}}</ref> or [[optical coherence tomography]] ([[OCT]])<ref name="pmid19401282">{{cite journal |author=Ishibashi K, Kitabata H, Akasaka T |title=Intracoronary optical coherence tomography assessment of spontaneous coronary artery dissection |journal=[[Heart (British Cardiac Society)]] |volume=95 |issue=10 |pages=818 |year=2009 |month=May |pmid=19401282 |doi=10.1136/hrt.2008.158485 |url=}}</ref> can be used for diagnostic clarification. In fact, a definitive diagnosis of type 3 SCAD requires OCT or IVUS.<ref name="pmid26198289" /> IVUS/OCT should be considered the gold standard in diagnosing SCAD. OCT may be preferred to IVUS due to superiority in spatial resolution and clarity in identifying intramural hematomas and intimal tears, though IVUS is still quite adequate.<ref name="pmid24227590" | In the event that diagnosis of SCAD based on angiography is ambiguous, [[intravascular ultrasound]] ([[IVUS]])<ref name="pmid11835932">{{cite journal |author=Maehara A, Mintz GS, Castagna MT, ''et al.'' |title=Intravascular ultrasound assessment of spontaneous coronary artery dissection |journal=[[The American Journal of Cardiology]] |volume=89 |issue=4 |pages=466–8 |year=2002 |month=February |pmid=11835932 |doi= |url=}}</ref><ref name="pmid14760197">{{cite journal |author=Porto I, Banning AP |title=Intravascular ultrasound imaging in the diagnosis and treatment of spontaneous coronary dissection with drug-eluting stents |journal=[[The Journal of Invasive Cardiology]] |volume=16 |issue=2 |pages=78–80 |year=2004 |month=February |pmid=14760197 |doi= |url=}}</ref><ref name="pmid18513437">{{cite journal |author=Arnold JR, West NE, van Gaal WJ, Karamitsos TD, Banning AP |title=The role of intravascular ultrasound in the management of spontaneous coronary artery dissection |journal=[[Cardiovascular Ultrasound]] |volume=6 |issue= |pages=24 |year=2008 |pmid=18513437 |pmc=2429898 |doi=10.1186/1476-7120-6-24 |url=}}</ref> or [[optical coherence tomography]] ([[OCT]])<ref name="pmid19401282">{{cite journal |author=Ishibashi K, Kitabata H, Akasaka T |title=Intracoronary optical coherence tomography assessment of spontaneous coronary artery dissection |journal=[[Heart (British Cardiac Society)]] |volume=95 |issue=10 |pages=818 |year=2009 |month=May |pmid=19401282 |doi=10.1136/hrt.2008.158485 |url=}}</ref> can be used for diagnostic clarification. In fact, a definitive diagnosis of type 3 SCAD requires OCT or IVUS.<ref name="pmid26198289" /> IVUS/OCT should be considered the gold standard in diagnosing SCAD. OCT may be preferred to IVUS due to superiority in spatial resolution and clarity in identifying intramural hematomas and intimal tears, though IVUS is still quite adequate.<ref name="pmid24227590" /> | ||
{| class="wikitable" style="width: 80%; text-align: justify;" | {| class="wikitable" style="width: 80%; text-align: justify;" | ||
Line 20: | Line 19: | ||
! colspan="2" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Clinical Characteristics}} | ! colspan="2" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Clinical Characteristics}} | ||
|- | |- | ||
| Connective tissue disorder (Marfan syndrome, Ehler-Danlos syndrome, cystic medial necrosis) / Fibromuscular Dysplasia | | | ||
* Connective tissue disorder (Marfan syndrome, Ehler-Danlos syndrome, cystic medial necrosis) / Fibromuscular Dysplasia | |||
| +2 | |||
|- | |- | ||
| Youth/<50 year | | | ||
* Youth/<50 year | |||
| +1 | |||
|- | |- | ||
| Estroprogestinic therapy | | | ||
* Estroprogestinic therapy | |||
| +1 | |||
|- | |- | ||
| No classical coronary risk factors | | | ||
* No classical coronary risk factors | |||
| +1 | |||
|- | |- | ||
| Pregnancy (peri-partum, history of multiple pregnancy)/ Female gender | | | ||
* Pregnancy (peri-partum, history of multiple pregnancy)/ Female gender | |||
| +1 | |||
|- | |- | ||
| History of coronary artery spasm/ Previous SCAD | | | ||
* History of coronary artery spasm/ Previous SCAD | |||
| +3 | |||
|- | |- | ||
| Amphetamines/Cocaine/ Vasospastic drug abuse | | | ||
* Amphetamines/Cocaine/ Vasospastic drug abuse | |||
| +1 | |||
|- | |- | ||
| Systematic inflammation (SLE, Chron disease, sarcoidosis, polyarteritis nodosa, Behcet's syndrome | | | ||
* Systematic inflammation (SLE, Chron disease, sarcoidosis, polyarteritis nodosa, Behcet's syndrome | |||
| +2 | |||
|- | |- | ||
| Emotional/ Physical stress | | | ||
* Emotional/ Physical stress | |||
| +1 | |||
|- | |- | ||
! colspan="2" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Angiographic Characteristics}} | ! colspan="2" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Angiographic Characteristics}} | ||
|- | |- | ||
| One vessel disease (no typical atherosclerotic lesions in order coronary arteries) | | | ||
* One vessel disease (no typical atherosclerotic lesions in order coronary arteries) | |||
| +1 | |||
|- | |- | ||
| Long/tortuose suspected lesion | | | ||
* Long/tortuose suspected lesion | |||
| +1 | |||
|- | |- | ||
| Diffuse, typically smooth arterial narrowing | | | ||
* Diffuse, typically smooth arterial narrowing | |||
| +1 | |||
|- | |- | ||
| colspan="2" | '''At least 3 points:''' Indication to perform endovascular imaging (OCT or, if not available, IVUS) | | colspan="2" | | ||
* '''At least 3 points:''' Indication to perform endovascular imaging (OCT or, if not available, IVUS) | |||
|- | |- | ||
| colspan="2" | In the presence of a score of at least three points in a patient presenting with chest pain, ECG/Echo abnormalities or troponin rise/fall, perform OCT/IVUS analysis for suspected SCAD. <ref name="pmid28149642">{{cite journal| author=Buccheri D, Zambelli G| title=Focusing on spontaneous coronary artery dissection: actuality and future perspectives. | journal=J Thorac Dis | year= 2016 | volume= 8 | issue= 12 | pages= E1784-E1786 | pmid=28149642 | doi=10.21037/jtd.2016.12.79 | pmc=5227193 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28149642 }} </ref> | | colspan="2" | | ||
* In the presence of a score of at least three points in a patient presenting with chest pain, ECG/Echo abnormalities or troponin rise/fall, perform OCT/IVUS analysis for suspected SCAD. <ref name="pmid28149642">{{cite journal| author=Buccheri D, Zambelli G| title=Focusing on spontaneous coronary artery dissection: actuality and future perspectives. | journal=J Thorac Dis | year= 2016 | volume= 8 | issue= 12 | pages= E1784-E1786 | pmid=28149642 | doi=10.21037/jtd.2016.12.79 | pmc=5227193 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28149642 }} </ref> | |||
|} | |} | ||
Revision as of 21:58, 11 December 2017
Spontaneous Coronary Artery Dissection Microchapters |
Differentiating Spontaneous coronary artery dissection from other Diseases |
---|
Diagnosis |
Treatment |
Case Studies |
Type 1 Type 2A Type 2B Type 3 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A. Arzu Kalayci, M.D. [2]
Synonyms and keywords: SCAD
Overview
The gold standard for the diagnosis of SCAD is conventional coronary angiography with intravascular imaging. Although exposure to radiation has always been a concern for especially pregnant or young women, this is the only way to make a definitive diagnosis.
Other Imaging Findings
Intravascular Ultrasound and Optical Coherence Tomogrpahy
In the event that diagnosis of SCAD based on angiography is ambiguous, intravascular ultrasound (IVUS)[1][2][3] or optical coherence tomography (OCT)[4] can be used for diagnostic clarification. In fact, a definitive diagnosis of type 3 SCAD requires OCT or IVUS.[5] IVUS/OCT should be considered the gold standard in diagnosing SCAD. OCT may be preferred to IVUS due to superiority in spatial resolution and clarity in identifying intramural hematomas and intimal tears, though IVUS is still quite adequate.[6]
Clinical-Angiographic Score System for SCAD Faster Diagnosis | |
---|---|
Clinical Characteristics | |
|
+2 |
|
+1 |
|
+1 |
|
+1 |
|
+1 |
|
+3 |
|
+1 |
|
+2 |
|
+1 |
Angiographic Characteristics | |
|
+1 |
|
+1 |
|
+1 |
| |
|
References
- ↑ Maehara A, Mintz GS, Castagna MT; et al. (2002). "Intravascular ultrasound assessment of spontaneous coronary artery dissection". The American Journal of Cardiology. 89 (4): 466–8. PMID 11835932. Unknown parameter
|month=
ignored (help) - ↑ Porto I, Banning AP (2004). "Intravascular ultrasound imaging in the diagnosis and treatment of spontaneous coronary dissection with drug-eluting stents". The Journal of Invasive Cardiology. 16 (2): 78–80. PMID 14760197. Unknown parameter
|month=
ignored (help) - ↑ Arnold JR, West NE, van Gaal WJ, Karamitsos TD, Banning AP (2008). "The role of intravascular ultrasound in the management of spontaneous coronary artery dissection". Cardiovascular Ultrasound. 6: 24. doi:10.1186/1476-7120-6-24. PMC 2429898. PMID 18513437.
- ↑ Ishibashi K, Kitabata H, Akasaka T (2009). "Intracoronary optical coherence tomography assessment of spontaneous coronary artery dissection". Heart (British Cardiac Society). 95 (10): 818. doi:10.1136/hrt.2008.158485. PMID 19401282. Unknown parameter
|month=
ignored (help) - ↑
- ↑
- ↑ Buccheri D, Zambelli G (2016). "Focusing on spontaneous coronary artery dissection: actuality and future perspectives". J Thorac Dis. 8 (12): E1784–E1786. doi:10.21037/jtd.2016.12.79. PMC 5227193. PMID 28149642.