Spontaneous coronary artery dissection history and symptoms: Difference between revisions
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==Symptoms== | ==Symptoms== | ||
The symptoms of SCAD mimic other [[acute coronary syndromes]] | The symptoms of SCAD mimic other [[acute coronary syndromes]]. | ||
* The most common symptom is an acute and severe onset of chest pain that may radiate to jaw and left arm. | |||
Patients may present with:<ref name="pmid8673763">{{cite journal| author=Zampieri P, Aggio S, Roncon L, Rinuncini M, Canova C, Zanazzi G et al.| title=Follow up after spontaneous coronary artery dissection: a report of five cases. | journal=Heart | year= 1996 | volume= 75 | issue= 2 | pages= 206-9 | pmid=8673763 | doi= | pmc=484263 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8673763 }} </ref> | |||
* [[chronic stable angina]] | |||
* [[myocardial infarction]] | |||
** 25% to 50% of cases are [[ST elevation myocardial infarction|STEMI]] | |||
* [[cardiogenic shock]] | |||
* [[sudden death]] | |||
** 50% of sudden death cases were reported to have dissections in the left main coronary artery.<ref name="pmid8665336">{{cite journal| author=Basso C, Morgagni GL, Thiene G| title=Spontaneous coronary artery dissection: a neglected cause of acute myocardial ischaemia and sudden death. | journal=Heart | year= 1996 | volume= 75 | issue= 5 | pages= 451-4 | pmid=8665336 | doi= | pmc=484340 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8665336 }} </ref> | |||
* [[pericardial tamponade]] | |||
Patients are typically asymptomatic on follow up.<ref name="pmid8673763" /> | |||
==References== | ==References== |
Revision as of 19:00, 1 December 2017
Spontaneous Coronary Artery Dissection Microchapters |
Differentiating Spontaneous coronary artery dissection from other Diseases |
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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.
Synonyms and keywords: SCAD
Overview
History
Patients presenting with typical symptoms of acute coronary syndromes and the following clinical characteristics may have suspected spontaneous coronary artery dissection (SCAD):
- Physical exertion[1]
- Emotional stress[2]
- Women with an average age ranging from 43 to 50 years[3][4]
- Postpartum status or history of pregnancy[5]
- History of smoking
- Atherosclerosis
- Cocaine abuse[6]
- Presence of a Connective tissue disorder: Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome type 4, cystic medial necrosis, alpha-1 antitrypsin deficiency, or polycystic kidney disease[7]
Many patients do not have a previous history of cardiovascular disease or other risk factors and SCAD is idopathic.[3]
Symptoms
The symptoms of SCAD mimic other acute coronary syndromes.
- The most common symptom is an acute and severe onset of chest pain that may radiate to jaw and left arm.
Patients may present with:[8]
- chronic stable angina
- myocardial infarction
- 25% to 50% of cases are STEMI
- cardiogenic shock
- sudden death
- 50% of sudden death cases were reported to have dissections in the left main coronary artery.[9]
- pericardial tamponade
Patients are typically asymptomatic on follow up.[8]
References
- ↑ Azam MN, Roberts DH, Logan WF (1995). "Spontaneous coronary artery dissection associated with oral contraceptive use". Int J Cardiol. 48 (2): 195–8. PMID 7775001.
- ↑ Saw, Jacqueline; Ricci, Donald; Starovoytov, Andrew; Fox, Rebecca; Buller, Christopher E. (2013). "Spontaneous Coronary Artery Dissection". JACC: Cardiovascular Interventions. 6 (1): 44–52. doi:10.1016/j.jcin.2012.08.017. ISSN 1936-8798.
- ↑ 3.0 3.1 Saw J, Aymong E, Sedlak T, Buller CE, Starovoytov A, Ricci D; et al. (2014). "Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes". Circ Cardiovasc Interv. 7 (5): 645–55. doi:10.1161/CIRCINTERVENTIONS.114.001760. PMID 25294399.
- ↑ Tweet MS, Hayes SN, Pitta SR, Simari RD, Lerman A, Lennon RJ; et al. (2012). "Clinical features, management, and prognosis of spontaneous coronary artery dissection". Circulation. 126 (5): 579–88. doi:10.1161/CIRCULATIONAHA.112.105718. PMID 22800851.
- ↑ Vijayaraghavan, R.; Verma, S.; Gupta, N.; Saw, J. (2014). "Pregnancy-Related Spontaneous Coronary Artery Dissection". Circulation. 130 (21): 1915–1920. doi:10.1161/CIRCULATIONAHA.114.011422. ISSN 0009-7322.
- ↑ Jaffe, Brian D.; Broderick, Thomas M.; Leier, Carl V. (1994). "Cocaine-Induced Coronary-Artery Dissection". New England Journal of Medicine. 330 (7): 510–511. doi:10.1056/NEJM199402173300719. ISSN 0028-4793.
- ↑ Saw, J.; Aymong, E.; Sedlak, T.; Buller, C. E.; Starovoytov, A.; Ricci, D.; Robinson, S.; Vuurmans, T.; Gao, M.; Humphries, K.; Mancini, G. B. J. (2014). "Spontaneous Coronary Artery Dissection: Association With Predisposing Arteriopathies and Precipitating Stressors and Cardiovascular Outcomes". Circulation: Cardiovascular Interventions. 7 (5): 645–655. doi:10.1161/CIRCINTERVENTIONS.114.001760. ISSN 1941-7640.
- ↑ 8.0 8.1 Zampieri P, Aggio S, Roncon L, Rinuncini M, Canova C, Zanazzi G; et al. (1996). "Follow up after spontaneous coronary artery dissection: a report of five cases". Heart. 75 (2): 206–9. PMC 484263. PMID 8673763.
- ↑ Basso C, Morgagni GL, Thiene G (1996). "Spontaneous coronary artery dissection: a neglected cause of acute myocardial ischaemia and sudden death". Heart. 75 (5): 451–4. PMC 484340. PMID 8665336.