User:Mr. Ibrahem/Spontaneous coronary artery dissection
| Spontaneous coronary artery dissection | |
|---|---|
| Other names | Coronary artery dissection |
 | |
| Coronary artery dissection involves the formation of a false opening which fills with blood (purple) within the walls of a coronary artery. | |
| Specialty | Cardiology |
| Symptoms | Chest pain, shortness of breath, sweating, nausea, increased heart enzymes[1] |
| Complications | Heart failure, sudden death[1] |
| Usual onset | Young and middle aged women[1] |
| Risk factors | Pregnancy, fibromuscular dysplasia, connective tissue disorders, inflammatory conditions[1] |
| Diagnostic method | Angiography[1] |
| Differential diagnosis | Other causes of acute coronary syndrome, Takotsubo cardiomyopathy[1] |
| Treatment | Conservative, percutaneous coronary intervention (PCI), coronary artery bypass surgery (CABG)[1] |
| Medication | Beta blockers, aspirin[1] |
| Prognosis | Generally good[1] |
| Frequency | Uncommon[1] |
Spontaneous coronary artery dissection (SCAD) is when one of the arteries that supply the heart develops a separation within it wall that fills with blood.[1] Symptoms are those of a heart attack, with chest pain, shortness of breath, sweating, nausea, and increased heart enzymes.[1] Complications can include heart failure and sudden death.[1]
Risk factors such as pregnancy, fibromuscular dysplasia, connective tissue disorders, and inflammatory conditions, are often present.[1] Triggers may include vomiting, coughing, or emotional stress.[1] The underlying mechanism involves a tear in the inner lining of an artery that supplies the heart, allowing blood to enter and separate the layers of the wall of the artery.[1] This narrows the artery resulting in decrease blood flow.[1] Diagnosis is usually by angiography, though a number of other types of medical imaging may be used.[1]
The best way to manage the condition is not entirely clear.[1] Conservative treatment is generally preferred over percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG).[1] Beta blockers and aspirin may be recommended long-term.[1] While the risk of death is less than 5%, some type of surgery is required in 15%, and about 10% recur.[1]
SCAD is uncommon.[1] It is estimated to represent between 0.1% and 4% of acute coronary syndrome cases.[1][2] Young and middle aged women are most commonly affected.[1] It was first described in 1931 during an autopsy.[2][3]
References[edit]
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y Parekh, JD; Chauhan, S; Porter, JL (January 2021). "Coronary Artery Dissection". PMID 29083832.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b Yip, A; Saw, J (February 2015). "Spontaneous coronary artery dissection-A review". Cardiovascular diagnosis and therapy. 5 (1): 37–48. doi:10.3978/j.issn.2223-3652.2015.01.08. PMID 25774346.
- ^ Pretty HC (18 April 1931). "Dissecting aneurysm of coronary artery in a woman aged 42". British Medical Journal. 1 (3667): 667. doi:10.1136/bmj.1.3667.667.