title: Clinical features of spontaneous coronary artery dissection.
abstract: BACKGROUND
  Spontaneous coronary artery dissection (SCAD) is an infrequent but increasingly recognized cause of acute coronary syndrome (ACS). Previous case reports demonstrated that this condition occurs in young females with a low atherosclerotic risk factor burden and may be associated with peripartum or postpartum status. The purpose of this study was to review patients with angiographically confirmed SCAD to provide additional insight into the diagnosis and treatment of this condition.
  
  
  RESULTS
  We screened medical records of all patients with ACS from March 2001 to November 2012. From these patients, we selected patients with SCAD based on coronary angiographic review. Of a total of 1159 ACS patients, 10 patients (0.86%) were diagnosed with SCAD. The mean age of these patients was 46 years, and 9 were female. ST-elevation myocardial infarction (STEMI) was observed in 9 patients and 5 patients had no coronary risk factors. One patient was treated conservatively with medication alone and 3 patients underwent thrombectomy. Balloon angioplasty was performed in 2 patients, and a bare metal stent was placed in one of these patients later. In the remaining 4 patients, bare metal stents were implanted emergently. Follow-up coronary angiography showed appropriate repair of SCAD in all 10 patients.
  
  
  CONCLUSIONS
  In our experience, the clinical features of SCAD appear to be similar to those reported previously. SCAD appears to be rare, but it should be considered in ACS patients, especially in younger females.
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Tokura
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan. Electronic address: taguchi@dokkyomed.ac.jp.
authors.forename: Isao
authors.initials: I
authors.lastname: Taguchi
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan.
authors.forename: Michiya
authors.initials: M
authors.lastname: Kageyama
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Nasuno
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Nishiyama
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Koshiji
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Koizumi
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Uehara
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan.
authors.forename: Yukitomo
authors.initials: Y
authors.lastname: Ogino
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Toyoda
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan.
authors.forename: Shichiro
authors.initials: S
authors.lastname: Abe
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan.
authors.forename: Teruo
authors.initials: T
authors.lastname: Inoue
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology; D000328:Adult; D000367:Age Factors; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015607:Stents; D017131:Thrombectomy; D018084:Ultrasonography, Interventional; D014652:Vascular Diseases / Q000150:complications / Q000151:congenital* / Q000175:diagnosis / Q000628:therapy
chemical_list: D008670:Metals
keywords: Acute coronary syndrome; Female; Low coronary risk factors; Peripartum or postpartum; Spontaneous coronary artery dissection