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Isolierte spontane Koronararterien-Dissektion

Isolated spontaneous coronary artery dissection — contribution to the differential diagnosis of coronary heart disease

Ein Beitrag zur Differentialdiagnose der koronaren Herzkrankheit

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Summary

A complete review of the literature on the disease entity isolated spontaneous coronary artery dissection (72 ascertained cases with our own three) is given. The emphasis is placed on differential diagnosis of coronary heart disease, particularly in young patients without typical atherosclerotic risk factors. Isolated spontaneous coronary artery dissection is defined as a spontaneously dissecting hematoma limited to one or more coronary arteries. Women are involved considerably more frequently than men (84% of cases). Mean age at onset of the disease is 41 years (range: 21–70 years). The main site of involvement is the left coronary artery (79% of cases). In one-third of the female patients there is a temporal relationship to pregnancy (peripartum coronary artery dissection). Three types can be differentiated by coronary arteriography. Less than one-third of the patients survive the first 24 h after acute onset of symptoms; attempts at emergency reperfusion of the ischemic myocardium by aortocoronary bypass surgery or thrombolytic therapy have not been successful.

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Abbreviations

ISKD:

isolierte spontane Koronararterien-Dissektion

RIA:

Ramus interventricularis anterior

i.c.:

intrakoronar

LH:

linkskoronarer Hauptstamm

R:

rechte Koronararterie

L:

Lumen

DK:

Dissektionskanal

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Authors and Affiliations

  1. Pathologisches Institut der Universität Heidelberg, Germany

    T. Mattfeldt

  2. Abteilung Innere Medizin III (Kardiologie) der Medizinischen Universitätsklinik Heidelberg, Germany

    F. Schwarz & W. Kübler

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  1. T. Mattfeldt
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  2. F. Schwarz
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  3. W. Kübler
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Mattfeldt, T., Schwarz, F. & Kübler, W. Isolierte spontane Koronararterien-Dissektion. Klin Wochenschr 64, 186–193 (1986). https://doi.org/10.1007/BF01713461

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  • DOI: https://doi.org/10.1007/BF01713461

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