Netherlands Heart Journal

, Volume 16, Issue 10, pp 344–349

Spontaneous coronary artery dissection: current insights and therapy

  • W. Tanis
  • P. R. Stella
  • A. H. Pijlman
  • J. H. Kirkels
  • R. H. J. Peters
  • F. H. de Man
case report

DOI: 10.1007/BF03086176

Cite this article as:
Tanis, W., Stella, P.R., Pijlman, A.H. et al. NHJL (2008) 16: 344. doi:10.1007/BF03086176
recurrence spontaneous coronary artery dissection connective tissue disorder peripartum episode atherosclerosis 

Abstract

Spontaneous coronary artery dissection (SCAD) is a very rare cause of acute coronary syndromes in young otherwise healthy patients with a striking predilection for the female gender. The pathological mechanism has not been fully clarified yet. However, several diseases and conditions have been associated with SCAD, such as atherosclerosis, connective tissue disorders and the peripartum episode. In this paper we present a review of the literature, discussing the possible mechanisms for SCAD, therapeutic options and prognosis. The review is illustrated with two SCAD patients who had a recurrence of a spontaneous dissection in another artery within a few days after the initial event. Because of the susceptibility to recurrent spontaneous dissections we propose at least one week of observation in hospital. Further, we will elaborate on the possible conservative and invasive treatment strategies in the acute phase of SCAD. Primary percutaneous coronary intervention remains the reperfusion strategy of choice; however, in small and medium-sized arteries with normalised flow conservative treatment is defendable. In addition, after the acute phase evaluation of possible underlying diseases is necessary, because it affects further treatment. (Neth Heart J 2008;16:344-9.)

Copyright information

© Bohn Stafleu van Loghum 2008

Authors and Affiliations

  • W. Tanis
    • 1
  • P. R. Stella
  • A. H. Pijlman
  • J. H. Kirkels
  • R. H. J. Peters
  • F. H. de Man
  1. 1.