World Library  
Flag as Inappropriate
Email this Article

Coronary artery dissection

Article Id: WHEBN0024946732
Reproduction Date:

Title: Coronary artery dissection  
Author: World Heritage Encyclopedia
Language: English
Subject: Right atrial enlargement, Atrial enlargement, Intraventricular block, Coronary artery aneurysm, Myocardial scarring
Collection: Causes of Death, Diseases of the Aorta, Heart Diseases
Publisher: World Heritage Encyclopedia
Publication
Date:
 

Coronary artery dissection

Coronary artery dissection
Classification and external resources
ICD-10 I25.4
ICD-9 414.12
DiseasesDB 3115

A coronary artery dissection (also known as spontaneous coronary artery dissection, or SCAD) is a rare, sometimes fatal traumatic condition, with eighty percent of cases affecting women. The coronary artery develops a tear, causing blood to flow between the layers which forces them apart.[1] Early studies of the disease placed mortality rates at around 70% but more recent data indicate this figure may be closer to 18%.[2]

Contents

  • Signs and symptoms 1
  • Causes 2
    • SCAD 2.1
  • Pathophysiology 3
  • Diagnosis 4
  • Treatment 5
  • Epidemiology 6
  • See also 7
  • References 8
  • External links 9

Signs and symptoms

The symptoms are often very similar to those of myocardial infarction (heart attack), with the most common being persistent chest pain.[3]

Causes

SCAD

There is evidence to suggest that a major cause of spontaneous coronary artery dissection (SCAD) is related to female hormone levels, as most cases appear to arise in pre-menopausal women, although there is evidence that the condition can have various triggers; other underlying conditions such as hypertension may sometimes be causes.[4] There is also a possibility that exercise can be a trigger. However cases sometimes have no obvious cause.[5]

Pathophysiology

Coronary artery dissection results from a tear in the inner layer of the artery, the tunica intima. This allows blood to penetrate and cause an intramural hematoma in the central layer, the tunica media, and a restriction in the size of the lumen, resulting in reduced blood flow which in turn causes myocardial infarction and can later cause sudden cardiac death.[6][7]

Diagnosis

A selective coronary angiogram is the most common method to diagnose the condition, although it is sometimes not recognised until after death.[8] Intravascular ultrasound (IVUS) is also used as it is able to more easily differentiate the condition from atherosclerotic disease.[9]

Treatment

Treatment is varied depending upon the nature of the case. In severe cases, coronary artery bypass surgery is performed to redirect blood flow around the affected area.[10] Drug-eluting stents and thrombolytic drug therapy are less invasive options for less severe cases.[9]

Epidemiology

Eighty percent of cases are in women. [11]

See also

References

  1. ^ Robert Slight; Ali Asgar Behranwala; Onyekwelu Nzewi; Rajesh Sivaprakasam; Edward Brackenbury; Pankaj Mankad (2003) "Spontaneous coronary artery dissection: a report of two cases occurring during menstruation" New Zealand Medical Journal]
  2. ^ "Clinical course and long-term prognosis of spontaneous coronary artery dissection. "
  3. ^ "Spontaneous Coronary Artery Dissection Postpartum"
  4. ^ Dhawan R, Singh G, Fesniak H. (2002) "Spontaneous coronary artery dissection: the clinical spectrum". Angiology
  5. ^ Mark V. Sherrid; Jennifer Mieres; Allen Mogtader; Naresh Menezes; Gregory Steinberg (1995) "Onset During Exercise of Spontaneous Coronary Artery Dissection and Sudden Death. Occurrence in a Trained Athlete: Case Report and Review of Prior Cases" Chest
  6. ^ Virmani R, Forman MB, Rabinowitz M, McAllister HA (1984) "Coronary artery dissections" Cardiol Clinics
  7. ^ Kamineni R, Sadhu A, Alpert JS. (2002) "Spontaneous coronary artery dissection: Report of two cases and 50-year review of the literature" Cardiol Rev
  8. ^ C. Basso, G. L. Morgagni, G. Thiene (1996) "Spontaneous coronary artery dissection: a neglected cause of acute myocardial ischaemia and sudden death" BMJ
  9. ^ a b Intravascular Ultrasound Imaging in the Diagnosis and Treatment: The Future: IVUS-Guided DES Implantation?
  10. ^ MedHelp:Coronary artery dissection treatment
  11. ^ Hayes, S (2013), New Insights into This Not-So-Rare Condition

External links

  • "Spontaneous Coronary Artery Dissection Postpartum"
  • "Spontaneous-Coronary-Artery-Dissection-Case-Series-and-Review"
This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and USA.gov, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for USA.gov and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
 
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
 
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.
 



Copyright © World Library Foundation. All rights reserved. eBooks from World eBook Library are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.