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Spontaneous Coronary Artery Dissection: Mini-Review

Marek M Rogowski, Christian Eichhorn, Kaffer Kara, Matthias Frick

Spontaneous Coronary Artery Dissection (SCAD) is a rare form of Acute Coronary Syndrome (ACS) affecting predominantly young non-pregnant females. The primary pathology features a spontaneous tearing event in the tunica media of a coronary artery wall with subsequent formation of a true and false lumen. This usually leads to non-atherosclerotic myocardial infarction. The diagnosis must be confirmed by a diagnostic angiography, preferably with intracoronary imaging such as Optical Coherence Tomography (OCT). Whereas most cases may be treated conservatively, a coronary intervention remains a safe and effective option in occlusive dissections or when a considerable amount of myocardium in jeopardy can be seen. The possible interventional techniques involve a balloon angioplasty, cutting angioplasty, limited wiring and/or stenting. Due to low mortality and good prognosis, this condition may present the most benign type of ACS. Still, the recurrence rate is up to 10% within the first five years.