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Spontaneous coronary artery dissection: Case series and review of literature

AIM: Spontaneous coronary artery dissection (SCAD) is a less recognized cause of ST elevation myocardial infarction (STEMI) in clinical practice. The aim of this communication is to describe a case series in South Asian population and highlight on the long-term clinical outcomes on conservative mana...

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Autores principales: Sharma, Satyavan, Raut, Nikhil, Potdar, Anil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990736/
https://www.ncbi.nlm.nih.gov/pubmed/27543469
http://dx.doi.org/10.1016/j.ihj.2015.11.039
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author Sharma, Satyavan
Raut, Nikhil
Potdar, Anil
author_facet Sharma, Satyavan
Raut, Nikhil
Potdar, Anil
author_sort Sharma, Satyavan
collection PubMed
description AIM: Spontaneous coronary artery dissection (SCAD) is a less recognized cause of ST elevation myocardial infarction (STEMI) in clinical practice. The aim of this communication is to describe a case series in South Asian population and highlight on the long-term clinical outcomes on conservative management. METHODS: A retrospective analysis of data of five patients (6 instances) of SCAD managed in a tertiary care center during January 1994 to June 2015 was done. Clinical, angiographic, therapeutic, and follow-up data till end of June 2015 are analyzed. RESULTS: All patients were young (mean – 33 years) and predominantly male. Etiology of SCAD was diverse and included peripartum state, vigorous activity and atherosclerosis. Left anterior descending (LAD) coronary artery was predominantly involved and the majority had angiographic type 1 SCAD. Medical treatment provides excellent long-term benefits. Coronary stenting provided symptomatic benefit in a patient with favorable anatomy. CONCLUSIONS: Clinical recognition of SCAD is difficult. It should be suspected in peripartum state, young females and in presence of other precipitating factors. Coronary angiography is essential for establishing the diagnosis. Medical treatment provides favorable long-term survival. IMPLICATIONS AND PRACTICE: The awareness of SCAD is important for all clinicians involved in STEMI care. A prompt suspicion can avoid administration of thrombolytic therapy. Early coronary angiography will provide an accurate diagnosis and help in deciding appropriate therapy. Percutaneous intervention can be challenging.
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spelling pubmed-49907362017-07-01 Spontaneous coronary artery dissection: Case series and review of literature Sharma, Satyavan Raut, Nikhil Potdar, Anil Indian Heart J Original Article AIM: Spontaneous coronary artery dissection (SCAD) is a less recognized cause of ST elevation myocardial infarction (STEMI) in clinical practice. The aim of this communication is to describe a case series in South Asian population and highlight on the long-term clinical outcomes on conservative management. METHODS: A retrospective analysis of data of five patients (6 instances) of SCAD managed in a tertiary care center during January 1994 to June 2015 was done. Clinical, angiographic, therapeutic, and follow-up data till end of June 2015 are analyzed. RESULTS: All patients were young (mean – 33 years) and predominantly male. Etiology of SCAD was diverse and included peripartum state, vigorous activity and atherosclerosis. Left anterior descending (LAD) coronary artery was predominantly involved and the majority had angiographic type 1 SCAD. Medical treatment provides excellent long-term benefits. Coronary stenting provided symptomatic benefit in a patient with favorable anatomy. CONCLUSIONS: Clinical recognition of SCAD is difficult. It should be suspected in peripartum state, young females and in presence of other precipitating factors. Coronary angiography is essential for establishing the diagnosis. Medical treatment provides favorable long-term survival. IMPLICATIONS AND PRACTICE: The awareness of SCAD is important for all clinicians involved in STEMI care. A prompt suspicion can avoid administration of thrombolytic therapy. Early coronary angiography will provide an accurate diagnosis and help in deciding appropriate therapy. Percutaneous intervention can be challenging. Elsevier 2016 2016-01-12 /pmc/articles/PMC4990736/ /pubmed/27543469 http://dx.doi.org/10.1016/j.ihj.2015.11.039 Text en © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Sharma, Satyavan
Raut, Nikhil
Potdar, Anil
Spontaneous coronary artery dissection: Case series and review of literature
title Spontaneous coronary artery dissection: Case series and review of literature
title_full Spontaneous coronary artery dissection: Case series and review of literature
title_fullStr Spontaneous coronary artery dissection: Case series and review of literature
title_full_unstemmed Spontaneous coronary artery dissection: Case series and review of literature
title_short Spontaneous coronary artery dissection: Case series and review of literature
title_sort spontaneous coronary artery dissection: case series and review of literature
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990736/
https://www.ncbi.nlm.nih.gov/pubmed/27543469
http://dx.doi.org/10.1016/j.ihj.2015.11.039
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