title: Spontaneous coronary artery dissection.
abstract: Spontaneous coronary artery dissection (SCAD) is a relatively rare and unexplored type of coronary disease. Although atherosclerosis, hormonal changes during pregnancy and connective tissue disorders might represent a sufficiently convincing explanation for some patients with SCAD, the many remaining cases display only a weak relationship with these causes. While on one side the clinical heterogeneity of SCAD masks a full understanding of their underlying pathophysiologic process, on the other side paucity of data and misleading presentations hamper the quick diagnosis and optimal management of this condition. A definite diagnosis of SCAD can be significantly facilitated by endovascular imaging techniques. In fact, intravascular ultrasound (IVUS) and optical coherence tomography (OCT) overcome the limitations of coronary angiography providing detailed endovascular morphologic information. In contrast, optimal treatment strategies for SCAD still represent a burning controversial question. Herein, we review the published data examining possible causes and investigating the best therapy for SCAD in different clinical scenarios.
authors.affiliation: Institute of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Giacoppo
authors.affiliation: Institute of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy; ETNA Foundation, Catania, Italy. Electronic address: dcapodanno@gmail.com.
authors.forename: Davide
authors.initials: D
authors.lastname: Capodanno
authors.affiliation: Department of Cardiology, Mount Sinai Medical Center, NY, United States; Cardiovascular Research Foundation, NY, United States.
authors.forename: George
authors.initials: G
authors.lastname: Dangas
authors.affiliation: Institute of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy; ETNA Foundation, Catania, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
mesh_terms: D000818:Animals; D017023:Coronary Angiography / Q000379:methods; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D041623:Tomography, Optical Coherence / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods; D014652:Vascular Diseases / Q000151:congenital* / Q000000981:diagnostic imaging / Q000628:therapy
keywords: Dissection; SCAD; Spontaneous coronary artery dissection