title: [Spontaneous coronary artery dissection can cause acute coronary syndrome. Unusual condition that requires thoughtful management and more research].
abstract: Spontaneous coronary artery dissection (SCAD) is a non-traumatic and non-iatrogenic injury occurring in the vessel wall caused by either a primary intimal dissection or a primary hematoma in the medial layer. SCAD is more common among women than men and accounts for a small minority of acute coronary syndromes. The causes of SCAD are multifactorial. Peripartum SCAD is most common. Fibromuscular dysplasia has a strong association with SCAD. As spontaneous healing is common in SCAD and PCI is associated with complications an initial conservative approach should always be considered. Medical treatment is based on the underlying cause. Beta blockers are recommended to all patients. The prognosis varies; the highest mortality is reported among women suffering peripartum SCAD. Quality of life is often affected in SCAD patients and accompanied by a high rate of rehospitalizations. More research which focuses on the underlying causes, optimal treatment and rehabilitation is needed.
authors.affiliation: Akademiska sjukhuset - Kardiologkliniken Uppsala, Sweden Medical Sciences - Cardiology Uppsala, Sweden.
authors.forename: Nina
authors.initials: N
authors.lastname: Johnston
authors.affiliation: Akademiska sjukhuset - Kardiologkliniken Uppsala, Sweden Uppsala kliniska forskningscentrum - Uppsala kliniska forskningscentrum Uppsala, Sweden.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Sarno
authors.affiliation: Akademiska sjukhuset - Bild och funktionsmedicinskt centrum Uppsala, Sweden Akademiska sjukhuset - Bild och funktionsmedicinskt centrum Uppsala, Sweden.
authors.forename: Bertil
authors.initials: B
authors.lastname: Larsson
authors.affiliation: Institutionen för klinisk forskning och utbildning, Södersjukhuset - Stockholm, Sweden - Stockholm, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Tornvall
authors.affiliation: Akademiska sjukhuset - Kardiolog kliniken Uppsala, Sweden Akademiska sjukhuset - Kardiolog kliniken Uppsala, Sweden.
authors.forename: Christoph
authors.initials: C
authors.lastname: Varenhorst
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D006801:Humans; D012737:Sex Factors; D014652:Vascular Diseases / Q000150:complications / Q000151:congenital* / Q000000981:diagnostic imaging / Q000628:therapy