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Invasive imaging modalities in a spontaneous coronary artery dissection: when “believing is seeing”

Spontaneous coronary artery dissection (SCAD) is a rare but increasingly recognized cause of acute coronary syndrome (ACS) with recent advancements in cardiac imaging facilitating its identification. However, SCAD is still often misdiagnosed due to the absence of angiographic hallmarks in a signific...

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Autores principales: Mehmedbegović, Zlatko, Ivanov, Igor, Čanković, Milenko, Perišić, Zoran, Kostić, Tomislav, Maričić, Bojan, Krljanac, Gordana, Beleslin, Branko, Apostolović, Svetlana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618678/
https://www.ncbi.nlm.nih.gov/pubmed/37920180
http://dx.doi.org/10.3389/fcvm.2023.1270259
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author Mehmedbegović, Zlatko
Ivanov, Igor
Čanković, Milenko
Perišić, Zoran
Kostić, Tomislav
Maričić, Bojan
Krljanac, Gordana
Beleslin, Branko
Apostolović, Svetlana
author_facet Mehmedbegović, Zlatko
Ivanov, Igor
Čanković, Milenko
Perišić, Zoran
Kostić, Tomislav
Maričić, Bojan
Krljanac, Gordana
Beleslin, Branko
Apostolović, Svetlana
author_sort Mehmedbegović, Zlatko
collection PubMed
description Spontaneous coronary artery dissection (SCAD) is a rare but increasingly recognized cause of acute coronary syndrome (ACS) with recent advancements in cardiac imaging facilitating its identification. However, SCAD is still often misdiagnosed due to the absence of angiographic hallmarks in a significant number of cases, highlighting the importance of meticulous interpretation of angiographic findings and, when necessary, additional usage of intravascular imaging to verify changes in arterial wall integrity and identify specific pathoanatomical features associated with SCAD. Accurate diagnosis of SCAD is crucial, as the optimal management strategies for patients with SCAD differ from those with atherosclerotic coronary disease. Current treatment strategies favor a conservative approach, wherein intervention is reserved for cases with persistent ischemia, patients with high-risk coronary anatomy, or patients with hemodynamic instability. In this paper, we provide a preview of invasive imaging modalities and classical angiographic and intravascular imaging hallmarks that may facilitate proper SCAD diagnosis.
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spelling pubmed-106186782023-11-02 Invasive imaging modalities in a spontaneous coronary artery dissection: when “believing is seeing” Mehmedbegović, Zlatko Ivanov, Igor Čanković, Milenko Perišić, Zoran Kostić, Tomislav Maričić, Bojan Krljanac, Gordana Beleslin, Branko Apostolović, Svetlana Front Cardiovasc Med Cardiovascular Medicine Spontaneous coronary artery dissection (SCAD) is a rare but increasingly recognized cause of acute coronary syndrome (ACS) with recent advancements in cardiac imaging facilitating its identification. However, SCAD is still often misdiagnosed due to the absence of angiographic hallmarks in a significant number of cases, highlighting the importance of meticulous interpretation of angiographic findings and, when necessary, additional usage of intravascular imaging to verify changes in arterial wall integrity and identify specific pathoanatomical features associated with SCAD. Accurate diagnosis of SCAD is crucial, as the optimal management strategies for patients with SCAD differ from those with atherosclerotic coronary disease. Current treatment strategies favor a conservative approach, wherein intervention is reserved for cases with persistent ischemia, patients with high-risk coronary anatomy, or patients with hemodynamic instability. In this paper, we provide a preview of invasive imaging modalities and classical angiographic and intravascular imaging hallmarks that may facilitate proper SCAD diagnosis. Frontiers Media S.A. 2023-10-18 /pmc/articles/PMC10618678/ /pubmed/37920180 http://dx.doi.org/10.3389/fcvm.2023.1270259 Text en © 2023 Mehmedbegović, Ivanov, Čanković, Perišić, Kostić, Maričić, Krljanac, Beleslin and Apostolović. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Mehmedbegović, Zlatko
Ivanov, Igor
Čanković, Milenko
Perišić, Zoran
Kostić, Tomislav
Maričić, Bojan
Krljanac, Gordana
Beleslin, Branko
Apostolović, Svetlana
Invasive imaging modalities in a spontaneous coronary artery dissection: when “believing is seeing”
title Invasive imaging modalities in a spontaneous coronary artery dissection: when “believing is seeing”
title_full Invasive imaging modalities in a spontaneous coronary artery dissection: when “believing is seeing”
title_fullStr Invasive imaging modalities in a spontaneous coronary artery dissection: when “believing is seeing”
title_full_unstemmed Invasive imaging modalities in a spontaneous coronary artery dissection: when “believing is seeing”
title_short Invasive imaging modalities in a spontaneous coronary artery dissection: when “believing is seeing”
title_sort invasive imaging modalities in a spontaneous coronary artery dissection: when “believing is seeing”
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618678/
https://www.ncbi.nlm.nih.gov/pubmed/37920180
http://dx.doi.org/10.3389/fcvm.2023.1270259
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