Presentation and patient characteristics Patients presenting with SCAD have a spectrum of clinical presentation, and fortunately, the majority appear to present with ACS with good in-hospital prognosis ( 13 ). [ncbi.nlm.nih.gov]

• Pain

  However, even after myocardial revascularization, she has had multiple episodes of chest pain requiring hospitalization. However, we have not been able to find a specific cause for it and the cause of her recurrent chest pain remains an enigma. [ncbi.nlm.nih.gov]

  “The bottom line is that any type of chest pain is abnormal,” Dr. Magliato said. “If you’re a young healthy woman and you have chest pain, you need to get medical attention.” Dr. [heart.org]

• Coronary Atherosclerosis

  Diagnosis is confirmed by a dissection flap that is seen on coronary angiogram in the absence of underlying coronary atherosclerosis. [ncbi.nlm.nih.gov]

  Patients dying of spontaneous coronary dissection are usually middle aged women, with no coronary atherosclerosis and apparently no risk factors. [heart.bmj.com]

  […] atherosclerotic coronary artery disease that thereby possibly affects the interpreters’ judgment, and a SCAD coronary appearance on CCTA that differs from that of typical atherosclerosis. 149, 151 Coronary atherosclerosis on CCTA commonly appears as [doi.org]

• Weakness

  We suggest that the loss of hormonal vascular smooth muscle cell suppression at the time of menstruation, as encountered in our patients, may lead to an increase in smooth muscle activity with resultant weakness in the coronary media. [web.archive.org]

  Affected coronary arteries may be inherently weak architecturally as a result of underlying arteriopathies, which can render them more susceptible to iatrogenic dissections and extension of dissections with PCI. [doi.org]

• Disability

  Two survivors maintained significant long-term disability. The patient that died had the diagnosis made on autopsy, the others were diagnosed with coronary angiography. [ncbi.nlm.nih.gov]

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• Chest Discomfort

  CONCLUSION: Chest discomfort was the most frequent presenting symptom with SCAD and one-third had unstable symptoms prompting urgent invasive angiography. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc. [ncbi.nlm.nih.gov]

  The presence of noncardiac pain should be a diagnosis of exclusion, but differentiating chest wall and musculoskeletal discomfort on the basis of reproducibility on physical examination can be reassuring. [doi.org]

• Chest Pain

  However, even after myocardial revascularization, she has had multiple episodes of chest pain requiring hospitalization. However, we have not been able to find a specific cause for it and the cause of her recurrent chest pain remains an enigma. [ncbi.nlm.nih.gov]

  “The bottom line is that any type of chest pain is abnormal,” Dr. Magliato said. “If you’re a young healthy woman and you have chest pain, you need to get medical attention.” Dr. [heart.org]

• Hypotension

  Despite thrombolysis, the patient’s condition deteriorated and she became hypotensive and oliguric. Echocardiography showed postero-lateral akinesis. [web.archive.org]

  In practice, β-blocker use is often limited by adverse effects, especially symptoms of fatigue and hypotension. [doi.org]

• Central Crushing Chest Pain

  Case 1 A 49-year-old female GP was admitted with a one-hour history of central, crushing chest pain. There was no history of cardiovascular disease or identifiable coronary risk factors. [web.archive.org]

• Back Pain

  Other symptoms included arm pain (49.5%), neck pain (22.1%), nausea or vomiting (23.4%), diaphoresis (20.9%), dyspnea (19.3%), and back pain (12.2%). Ventricular tachycardia/fibrillation occurred in 8.1% (16/196), with 1.0% having cardiac arrest. [ncbi.nlm.nih.gov]

• Neck Pain

  Other symptoms included arm pain (49.5%), neck pain (22.1%), nausea or vomiting (23.4%), diaphoresis (20.9%), dyspnea (19.3%), and back pain (12.2%). Ventricular tachycardia/fibrillation occurred in 8.1% (16/196), with 1.0% having cardiac arrest. [ncbi.nlm.nih.gov]

• Suggestibility

  She had no prior symptoms suggestive of SLE and the SCAD was its very first clinical manifestation. 2016 BMJ Publishing Group Ltd. [ncbi.nlm.nih.gov]

  This may suggest that increased shear forces and blood pressure may contribute to an intimal tear with progression of subsequent dissection in some patients. [invasivecardiology.com]

• Stroke

  Median long-term follow-up was 3.1 years, and overall major adverse cardiac event rate was 19.9% (death rate: 1.2%; recurrent MI: 16.8%; stroke/transient ischemic attack: 1.2%; revascularization: 5.8%). Recurrent SCAD occurred in 10.4% of patients. [ncbi.nlm.nih.gov]

  Fibromuscular dysplasia can also cause high blood pressure, a stroke and tears in other blood vessels. Fibromuscular dysplasia occurs more often in women than it does in men. Extreme physical exercise. [mayoclinic.org]

  There were 4 (2.4%) transient ischemic attack or stroke events (1 was a simultaneous vertebral dissection) in-hospital. There were 8 (4.8%) in-hospital recurrent MI. [dx.doi.org]

  […] on Cardiovascular and Stroke Nursing, and Council on Epidemiology and Prevention; American Heart Association; American Stroke Association. [doi.org]

• ST Elevation

  Twenty-two SCAD patients were matched to 66 controls by ACS type (ST-elevation myocardial infarction 45%, Non-ST-elevation myocardial infarction 41%, unstable angina 14%). [ncbi.nlm.nih.gov]

INTERVENTIONS: There is no guiding suggestion for the treatment of SCAD. The main treatment methods are 3 aspects: conservative internal medical treatment, stent implantation, coronary artery bypass grafting. [ncbi.nlm.nih.gov]

The etiology, pathogenesis, diagnosis, treatment, and prognosis of patients with coronary dissection are reviewed. [ncbi.nlm.nih.gov]

Patients who survive the acute phase have good long-term prognosis, with a very low recurrence rate of SCAD [10] or acute coronary syndrome [10, 21], and a 95% 2-year survival rate in the meta-analysis from Thompson et al. [22]. [doi.org]

KEYWORDS: Aneurysm, dissecting/complications/diagnosis/etiology/radiography; myocardial infarction/etiology; risk factors; treatment outcome; weight lifting/injuries [ncbi.nlm.nih.gov]

The aim of this paper is to review the epidemiology, etiology, presentation, diagnosis and management of SCAD. [ncbi.nlm.nih.gov]

A high number of conditions have been related to SCAD, but fibromuscular dysplasia has shown a major intriguing association with potential pathophysiological implications. [ncbi.nlm.nih.gov]

Several mechanisms have been described in the pathophysiology of this condition. Urgent coronary angiography is indicated if SCAD is suspected. [dx.doi.org]

The condition can’t currently be predicted or prevented. Those with SCAD are generally healthy. They often don’t smoke or have diabetes and aren’t usually overweight or obese. [bhf.org.uk]

Coronary artery fenestration with cutting balloon angioplasty prior to stenting can prevent the expansion of intramural hematoma and optimize PCI outcomes in this patient population. © 2015 Wiley Periodicals, Inc. [ncbi.nlm.nih.gov]