SCAD in Women

Jacqueline Saw, MD, FRCPC, FACC
Interventional Cardiology, Vancouver General Hospital
Clinical Associate Professor, University of British Columbia

The differential diagnosis of acute coronary syndromes in women includes both atherosclerotic and non-atherosclerotic etiologies. Spontaneous coronary artery dissection (SCAD) has recently become an increasingly recognized entity, particularly in young women (age ≤50 years). Despite recent increasing interests with SCAD, the diagnosis remains often missed due to subtle coronary angiographic appearances and non-familiarity with these appearances. Advances in intracoronary imaging have improved SCAD diagnosis, and allowed recognition of angiographic variants of SCAD. Our case report of multiple recurrent SCAD published in this month’s Journal of Invasive Cardiology highlights some of the challenges in the angiographic diagnosis of SCAD. Consideration to utilize adjunctive intracoronary imaging (optical coherence tomography or intravascular ultrasound) should improve diagnosis of SCAD in cases where angiographic diagnosis is uncertain.

Read the entire case report in this month’s Journal of Invasive Cardiology:

Khosla A, Saw J. Recurrent Spontaneous Coronary Artery Dissection in a Woman With Fibromuscular Dysplasia. J INVASIVE CARDIOL 2015;27(6):E110-E112

Other articles on Spontaneous Coronary Artery Dissection

Katikaneni PK, Akkus NI, Tandon N, Modi K. Cocaine-induced postpartum coronary artery dissection: a case report and 80-year review of literature. J Invasive Cardiol. 2013 Aug;25(8):E163-6. Review.

Pfeiffer M, Baquero G, Kozak M. Spontaneous coronary artery dissection: a case series highlighting diagnostic challenges and the potential for underestimating the incidence of this presumed rare disorder. J Invasive Cardiol. 2013 Jul;25(7):E159-62. Review.

Alfaqih MA, Michel Ortega RM, Yang EH. Spontaneous coronary artery dissection in an elderly woman presenting with chest pain and positive cardiac biomarkers. J Invasive Cardiol. 2012 Sep;24(9):E193-5.

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