Review Article
Volume 76, Issue 8, August 2020
JOURNAL：J Am Coll Cardiol.
Article Link
Spontaneous Coronary Artery Dissection: JACC State-of-the-Art Review
SN Hayes, MS Tweet, D Adlam et al.
KEYWORDS
fibromuscular dysplasia; genetics; myocardial infarction; pregnancy-associated SCAD; women
Over the past decade, spontaneous coronary artery dissection (SCAD) has
emerged as an important cause of myocardial infarction, particularly
among younger women. The pace of knowledge acquisition has been rapid,
but ongoing challenges include accurately diagnosing SCAD and improving
outcomes. Many SCAD patients experience substantial post-SCAD symptoms,
recurrent SCAD, and psychosocial distress. Considerable uncertainty
remains about optimal management of associated conditions, risk
stratification and prevention of complications, recommendations for
physical activity, reproductive planning, and the role of genetic
evaluations. This review provides a clinical update on the diagnosis and
management of patients with SCAD, including pregnancy-associated SCAD
and pregnancy after SCAD, and highlight high-priority knowledge gaps
that must be addressed.
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