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Spontaneous coronary artery dissection: an unpredictable event
Spontaneous coronary artery dissection (SCAD) is an under-recognized cause of acute coronary syndrome that predominantly affects women in adulthood and is the leading cause of acute myocardial infarction in pregnancy. The most common clinical presentation is ST-segment elevation myocardial infarctio...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10120938/ https://www.ncbi.nlm.nih.gov/pubmed/37091648 http://dx.doi.org/10.1093/eurheartjsupp/suad059 |
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author | Smirnova, Alexandra Aliberti, Flaminia Cavaliere, Claudia Gatti, Ilaria Vilardo, Viviana Giorgianni, Carmelina Cassani, Chiara Repetto, Alessandra Narula, Nupoor Giuliani, Lorenzo Urtis, Mario Ozaki, Yukio Prati, Francesco Arbustini, Eloisa Ferrari, Michela |
author_facet | Smirnova, Alexandra Aliberti, Flaminia Cavaliere, Claudia Gatti, Ilaria Vilardo, Viviana Giorgianni, Carmelina Cassani, Chiara Repetto, Alessandra Narula, Nupoor Giuliani, Lorenzo Urtis, Mario Ozaki, Yukio Prati, Francesco Arbustini, Eloisa Ferrari, Michela |
author_sort | Smirnova, Alexandra |
collection | PubMed |
description | Spontaneous coronary artery dissection (SCAD) is an under-recognized cause of acute coronary syndrome that predominantly affects women in adulthood and is the leading cause of acute myocardial infarction in pregnancy. The most common clinical presentation is ST-segment elevation myocardial infarction (STEMI) or non-STEMI, followed by cardiogenic shock (∼2%), sudden cardiac death (0.8% in autopsy series), cardiac arrest, ventricular arrhythmias (∼5%), and Takotsubo syndrome. The prevalence of SCAD in the general population is largely uncertain due to underdiagnosis. Oral contraceptives, post-menopausal therapy, and infertility treatments are recognized associated factors. The pathological substrates (fibromuscular dysplasia) and triggers (especially emotional stress) are commonly present in affected women. The few cases with a precise genetic aetiology occur in the context of syndromic and non-syndromic connective tissue diseases. The only true certainty in SCAD is the overwhelming prevalence in women. The first event as well as the recurrence (up to 30%, which varies depending on the definition) is largely unpredictable. The treatment strategy is highly individualized and requires extensive additional study in order to optimize outcomes and prevent major adverse cardiovascular events in affected individuals. We have known about SCAD for nearly a century, but we still do not know how best to prevent, diagnose, and treat it, making SCAD a highly important and unmet clinical need. |
format | Online Article Text |
id | pubmed-10120938 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-101209382023-04-22 Spontaneous coronary artery dissection: an unpredictable event Smirnova, Alexandra Aliberti, Flaminia Cavaliere, Claudia Gatti, Ilaria Vilardo, Viviana Giorgianni, Carmelina Cassani, Chiara Repetto, Alessandra Narula, Nupoor Giuliani, Lorenzo Urtis, Mario Ozaki, Yukio Prati, Francesco Arbustini, Eloisa Ferrari, Michela Eur Heart J Suppl CCC 2023 - State of the Art Cardiology Supplement Paper Spontaneous coronary artery dissection (SCAD) is an under-recognized cause of acute coronary syndrome that predominantly affects women in adulthood and is the leading cause of acute myocardial infarction in pregnancy. The most common clinical presentation is ST-segment elevation myocardial infarction (STEMI) or non-STEMI, followed by cardiogenic shock (∼2%), sudden cardiac death (0.8% in autopsy series), cardiac arrest, ventricular arrhythmias (∼5%), and Takotsubo syndrome. The prevalence of SCAD in the general population is largely uncertain due to underdiagnosis. Oral contraceptives, post-menopausal therapy, and infertility treatments are recognized associated factors. The pathological substrates (fibromuscular dysplasia) and triggers (especially emotional stress) are commonly present in affected women. The few cases with a precise genetic aetiology occur in the context of syndromic and non-syndromic connective tissue diseases. The only true certainty in SCAD is the overwhelming prevalence in women. The first event as well as the recurrence (up to 30%, which varies depending on the definition) is largely unpredictable. The treatment strategy is highly individualized and requires extensive additional study in order to optimize outcomes and prevent major adverse cardiovascular events in affected individuals. We have known about SCAD for nearly a century, but we still do not know how best to prevent, diagnose, and treat it, making SCAD a highly important and unmet clinical need. Oxford University Press 2023-04-21 /pmc/articles/PMC10120938/ /pubmed/37091648 http://dx.doi.org/10.1093/eurheartjsupp/suad059 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | CCC 2023 - State of the Art Cardiology Supplement Paper Smirnova, Alexandra Aliberti, Flaminia Cavaliere, Claudia Gatti, Ilaria Vilardo, Viviana Giorgianni, Carmelina Cassani, Chiara Repetto, Alessandra Narula, Nupoor Giuliani, Lorenzo Urtis, Mario Ozaki, Yukio Prati, Francesco Arbustini, Eloisa Ferrari, Michela Spontaneous coronary artery dissection: an unpredictable event |
title | Spontaneous coronary artery dissection: an unpredictable event |
title_full | Spontaneous coronary artery dissection: an unpredictable event |
title_fullStr | Spontaneous coronary artery dissection: an unpredictable event |
title_full_unstemmed | Spontaneous coronary artery dissection: an unpredictable event |
title_short | Spontaneous coronary artery dissection: an unpredictable event |
title_sort | spontaneous coronary artery dissection: an unpredictable event |
topic | CCC 2023 - State of the Art Cardiology Supplement Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10120938/ https://www.ncbi.nlm.nih.gov/pubmed/37091648 http://dx.doi.org/10.1093/eurheartjsupp/suad059 |
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