title: Spontaneous coronary artery dissection: a case series and literature review.
abstract: Spontaneous coronary artery dissection (SCAD) is a rare and often lethal cause of acute coronary syndrome, which typically affects young women and otherwise healthy individuals. SCAD can be diagnosed in patients undergoing coronary angiography and can be underestimated. Special techniques such as optical coherence tomography (OCT) and intravascular ultrasound should be used when there is suspicion of the condition. In the majority of cases, the left anterior descending (LAD) artery is involved; however, a few cases of the right coronary artery (RCA) involvement have been reported. This article describes three cases of SCAD in women of different ages, all presenting with chest pain. Coronary angiography in conjunction with OCT was used for diagnosis in two of the cases. One of the patients had involvement of the proximal RCA and underwent percutaneous coronary intervention, whereas the other two patients had mid-LAD disease and were treated conservatively with medical therapy. Presently, there are no specific guidelines for the treatment of SCAD, and therapy is individualized according to extent and severity of the condition.
authors.affiliation: Internal Medicine Resident PGY-3, The University of Iowa - Des Moines Internal Medicine Residency Program, IA, USA.
authors.forename: Nelson A Telles
authors.initials: NA
authors.lastname: Garcia
authors.affiliation: The University of Iowa - Des Moines Internal Medicine Residency Program, IA, USA ; The Iowa Clinic, West Des Moines, IA, USA.
authors.forename: Abul N
authors.initials: AN
authors.lastname: Khan
authors.affiliation: Internal Medicine Resident PGY-3, The University of Iowa - Des Moines Internal Medicine Residency Program, IA, USA.
authors.forename: Ratna C
authors.initials: RC
authors.lastname: Boppana
authors.affiliation: UnityPoint Health, Des Moines, IA, USA.
authors.forename: Hayden L
authors.initials: HL
authors.lastname: Smith
keywords: angina; coronary angiography; intravascular ultrasound; myocardial infarction; optical coherence tomography; spontaneous coronary artery dissection