Spontaneous coronary artery dissection:A review of diagnostic methods and management strategies  

作　　者：Nikolaos Lionakis Alexandros Briasoulis Virginia Zouganeli Stavros Dimopoulos Dionisios Kalpakos Christos Kourek 

机构地区：[1]Department of Cardiology,417 Army Share Fund Hospital of Athens(NIMTS),Athens 11521,Greece [2]Department of Clinical Therapeutics,Alexandra Hospital,Faculty of Medicine,National and Kapodistrian University of Athens,Athens 11528,Greece [3]Division of Cardiovascular Medicine,Section of Heart Failure and Transplantation,University of Iowa Hospitals and Clinics,IA 52242,United States [4]Second Cardiology Department,Attikon University Hospital,Faculty of Medicine,National and Kapodistrian University of Athens,Athens 12462,Greece [5]Clinical Ergospirometry,Exercise&Rehabilitation Laboratory,1 st Department of Critical Care Medicine,Evangelismos Hospital,Faculty of Medicine,National and Kapodistrian University of Athens,Athens 10676,Greece [6]Cardiac Surgery Intensive Care Unit,Onassis Cardiac Surgery Center,Athens 17674,Greece

出　　处：《World Journal of Cardiology》2022年第10期522-536,共15页世界心脏病学杂志（英文版）（电子版）

摘　　要：Spontaneous coronary artery dissection(SCAD)is a rare non-atherosclerotic cause of acute coronary syndromes defined as non-iatrogenic,non-traumatic separation of the coronary artery wall.The most common profile is a middle-aged woman between 44 and 53 years with few cardiovascular risk factors.SCAD is frequently linked with predisposing factors,such as postpartum,fibromuscular dysplasia or other vasculopathies,connective tissue disease and hormonal therapy,and it is often triggered by intense physical or emotional stress,sympathomimetic drugs,childbirth and activities increasing shear stress of the coronary artery walls.Patients with SCAD usually present at the emergency department with chest discomfort,chest pain,and rapid heartbeat or fluttery.During the last decades,the most common problem of SCAD was the lack of awareness about this condition which has led to significant underdiagnosis and misdiagnosis.However,modern imaging techniques such as optical coherence tomography,intravascular ultrasound,coronary angiography or magnetic resonance imaging have contributed to the early diagnosis of the disease.Treatment of SCAD remains controversial,especially during the last years,where invasive techniques are being used more often and in more emergent cardiac syndromes.Although conservative treatment combining aspirin and betablocker remains the recommended strategy in most cases,revascularization could also be suggested as a method of treatment in specific indications,but with a higher risk of complications.The prognosis of SCAD is usually good and long-term mortality seems to be low in these patients.Follow-up should be performed on a regular basis.

关 键 词：Spontaneous coronary artery dissection Non-atherosclerotic coronary artery disease Angiographic classification Percutaneous coronary intervention 

分 类 号：R541.4[医药卫生—心血管疾病]