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Idiopathic Spontaneous Coronary Artery Dissection

Idiopathic SCAD


Presentation

  • Key information is presented in tabular format wherever possible. A companion website will offer the fully searchable text and an image bank"--Provided by publisher.[books.google.com]
  • Clinical presentation was acute myocardial infarction in four cases and unstable angina pectoris in one of them.[ncbi.nlm.nih.gov]
  • Case presentation: This report describes a 35-year-old female who presented with an acute inferior ST elevation...[connection.ebscohost.com]
  • While coronary artery dissection may present as acute myocardial infarction or as sudden death, sudden death accounts for the majority of presentations, thus leading to diagnosis usually at autopsy.[omicsonline.org]
Pathologist
  • The book is geared to pathology residents and practicing surgical pathologists and focuses on illustrated practical diagnosis, including differential diagnosis.[books.google.com]
Splenectomy
Severe Abdominal Pain
  • .; Segal, David // Archives of Gynecology & Obstetrics;Oct2007, Vol. 276 Issue 3, p269 We present a case of a 24-year old, otherwise healthy, primigravida that was admitted at term with severe abdominal pain, hemoperitoneum, hypovolemic shock and severe[connection.ebscohost.com]
Hepatosplenomegaly
  • We report a case of a young female who was presented with atraumatic abdominal pain, hypovolemic shock, anemia, ascites and hepatosplenomegaly with a recent history of a febrile... Spontaneous Multiarterial Dissection Immediately after Childbirth.[connection.ebscohost.com]
Delayed Wound Healing
  • In addition, drug-eluting stents has the concern about delayed wound healing in the stent-injured vessel wall.[scitechnol.com]
Dyspareunia
  • Problems associated with endometriosis include dysmenorrhea, dyspareunia, and infertility. While endometriosis does not generally cause complications during pregnancy, endometriosis clearly causes complications before...[connection.ebscohost.com]

Workup

Microalbuminuria
  • ESC Congress 2011/2011-08-01 Impact of microalbuminuria on the characteristics of coronary plaques on computed tomography angiography. Sato A; Kakefuda Y; Adachi T; Ojima E; Watabe H; Atsumi A...[trios.tsukuba.ac.jp]
Hypercholesterolemia
  • She had no past medical history of collagen tissue disease or blunt trauma to the chest, was not on any medication and had a family history of hypercholesterolemia.[synapse.koreamed.org]

Treatment

  • Idiopathic Spontaneous Coronary Artery Dissection: Incidence, Diagnosis And Treatment نويسندگان: [ Micha Maeder ] - Division of Cardiology, Department of Internal Medicine, Hospital of St. Gallen, CH-9007 St.[scipers.com]
  • Less is known about characteristics, treatment and follow-up of patients with spontaneous coronary artery dissection (SCAD) without associated pregnancy or underlying atherosclerosis.[ncbi.nlm.nih.gov]
  • However, the optimal treatment strategy remains unknown. In this case report, we describe a patient with SCAD undergoing PCI, where intravascular ultrasound (IVUS) guidance was essential for successful treatment.[scitechnol.com]
  • The preferred treatment in symptomatic patients with SCAD is percutaneous intervention and stenting.[heartindia.net]
  • "The acute and long-term management of SCAD remains contentious as there have been no randomized controlled trials [RCTs] assessing optimal treatment strategy.[medpagetoday.com]

Prognosis

  • Long term prognosis is reported as variable.[scorgloballifeamericas.com]
  • The pattern and/or severity of presentation and prognosis are related to the vessels involved. For example, left main, left anterior descending and multi-vessel disease have the poorest prognosis.[gamma.wustl.edu]
  • 第58回六甲カルディアックセミナー/2011-08-06 Long-Term Prognosis of Stent Thrombosis Treated With Drug-Eluting and Bare-Metal Stents: From ICAS Registry. Kakefuda Y; Satoh Y; Takeyasu N; Ojima E; Naruse Y; Hoshi...[trios.tsukuba.ac.jp]
  • Retrospective Case-identification Denmark Heart Registry Study Describe incidence of SCAD Describe predictors of SCAD Describe prognosis of SCAD SCAD was identified in 22 of 32,869 (0.7%) of angiograms.[bestbets.org]
  • On the basis of this series and data from the literature, we suggest a strategy to improve the often dire prognosis of SCAD. Emergency angiography to confirm diagnosis is essential.[karger.com]

Etiology

  • Each chapter includes eight to ten gross and microscopic photographs with legends highlighting the pathologic features of the disease, as well as succinct text covering etiology, clinical aspects, and differential diagnosis.[books.google.com]
  • Massive spontaneous hemoperitoneum of unknown etiology: A case report. Suber, Jr., W.[connection.ebscohost.com]
  • Regarding the etiology, SCAD is classified broadly into two groups: atherosclerotic and non-atherosclerotic SCAD.[clinmedjournals.org]
  • We found 4 cases of SCAD unrelated to pregnancy where recent emotional stressors were postulated a contributing etiological factor in women [ 7, 8, 9, 10 ].[em-consulte.com]
  • The case of a 52-year-old woman with SCAD of unknown etiology is reported. 1. Tweet MS, Hayes SN, Pitta SR, et al. Clinical features, management, and prognosis of spontaneous coronary artery dissection.[degruyter.com]

Epidemiology

  • Portilla-Queved, Diego; Hernández-Giraldo, Cristian; Sarmiento-Hernández, Piedad; Zuluaga-Liberato, Andrea // Revista Colombiana de Obstetricia y Ginecologia;ene-mar2013, Vol. 64 Issue 1, p67 Objective: To undertake a review of the literature on the epidemiology[connection.ebscohost.com]
  • […] benefit from a more conservative therapy that focuses on controlling blood pressure, such as beta blockers. [18] Prognosis [ edit ] The condition is often fatal and is mostly recognized at postmortem examination in young victims of sudden death. [19] [20] Epidemiology[en.wikipedia.org]
  • The aim of this paper is to review the epidemiology, etiology, presentation, diagnosis and management of SCAD.[cdt.amegroups.com]
  • Epidemiology, Etiology, and Demographics SCAD prevalence remains uncertain and in retrospective studies has been reported as 0.07% to 1.1% (1,5–7).[imaging.onlinejacc.org]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of spontaneous coronary artery dissection during the peripartum period is poorly understood. We present a case of spontaneous multivessel dissection in a 32-year-old...[connection.ebscohost.com]
  • Acute Myocardial Infarction and Cocaine: Three Pathophysiological Models Abstract In recent years, growing cocaine use worldwide hasincreased the rate of associated cardiovascular complications.Some studies found that about 30% of the addictionvisits[ppct.caicyt.gov.ar]
  • The probable mechanisms associated with SCAD have been reported so that patients can be separated into three different pathophysiologic groups according to their condition: 1) the non-atherosclerotic, peripartum period group; 2) the atherosclerotic group[synapse.koreamed.org]
  • Although the cause of SCAD may be atherosclerotic or non-atherosclerotic, contemporary usage of the term "SCAD" has focused on and is synonymous with the non-atherosclerotic variant, which has distinct pathophysiology, management, and outcomes from atherosclerotic[raredr.com]
  • The pathophysiology involves hemorrhage between the medial layer and the external elastic lamina, leading to separation of the layers, expansion of a false lumen, and compression of the native lumen that results in ischemia. 2 Rupture and hemorrhage of[revespcardiol.org]

Prevention

  • Prevention - Coronary artery dissection Not supplied. Diagnosis - Coronary artery dissection SCAD's have been known to occur during exercise and at rest. SCAD's are usually diagnosed by angiogram and stenting may be necessary to re-open the artery.[checkorphan.org]
  • We also covered the entire lesion with coronary stents, including the hematoma, so as to prevent propagation to the distal vessel. In conclusion, SCAD is a very rare but serious cause of ACS.[synapse.koreamed.org]
  • For medical management, aspirin and beta-blocker are typically administered long-term for secondary thrombotic prevention and reduction of arterial shear-stress, respectively.[raredr.com]
  • Intracoronary thombus prevented visualization of the whole coronary structure in 61% of patients. 16 patients were withdrawn due to poor OCT images.[bestbets.org]
  • Beta-blockers and nitrates are often used to prevent superimposed vapospasm. In cases of myocardial ischemia or compromised coronary flow, reperfusion therapy is used. In patients with severe ischemia, coronary-artery bypass grafting is done.[web.colby.edu]

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