Spontaneous Coronary Artery Dissection: Current Concepts and Clinical Management.

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Publication Details

Journal
PubMed
Published
2026-09-04
DOI
https://doi.org/10.5543/tkda.2026.50511
Primary Topic
Cardiovascular Issues in Pregnancy
Type
article
Field-Weighted Citation Impact
0.00
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article

Spontaneous Coronary Artery Dissection: Current Concepts and Clinical Management.

Fuat Polat, Sait Terzi, Saeedreza Khatami, Ali Kerem Yılmaz et al.
PubMed
Cardiovascular Issues in Pregnancy
article

Spontaneous Coronary Artery Dissection: Current Concepts and Clinical Management.

Fuat Polat, Sait Terzi, Saeedreza Khatami, Ali Kerem Yılmaz, Ali Nazmi Çalık
article en

Abstract

Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic, noniatrogenic cause of acute coronary syndrome (ACS) that predominantly affects women, including those of reproductive age. Misdiagnosis as atherosclerotic coronary disease may lead to inappropriate interventions and antithrombotic therapy. This narrative review summarizes consensus statements, registry data, and observational studies published through July 2026 to provide a structured, clinically oriented overview of the diagnosis, acute management, and long-term care of SCAD. Most recommendations are based on observational studies or registry-level evidence; randomized trial data remain limited. A narrative review of the literature was performed using MEDLINE/PubMed, EMBASE, and the Cochrane Library. Search terms included "spontaneous coronary artery dissection," "SCAD," "fibromuscular dysplasia," "intramural hematoma," and related terms. The search was not date-restricted but was updated through July 2026. Priority was given to guideline documents, consensus statements, registries, systematic reviews, and original cohort studies. The review highlights the angiographic recognition of SCAD patterns and the selective use of intravascular imaging in ambiguous cases. A conservative management strategy is preferred in hemodynamically stable patients with preserved distal coronary flow and no objective evidence of ongoing ischemia, given the high rates of spontaneous healing and the risk of iatrogenic dissection. Revascularization may be considered in selected high-risk patients with ongoing ischemia or hemodynamic compromise. Long-term care includes individualized antiplatelet therapy, beta-blockers, extracoronary arteriopathy screening, rehabilitation, and counseling regarding pregnancy and trigger avoidance. This review provides a clinically applicable framework for SCAD diagnosis and management while highlighting persistent evidence gaps in antithrombotic strategies, recurrence prediction, and extracoronary screening.

PubMed
Dr. Siyami Ersek Göğüs Kalp Ve Damar Cerrahisi Eğitim Ve Araştırma Hastanesi (TR), Tehran University of Medical Sciences (IR)
Good health and well-being
Openalex Percentile: Top 10%
Cardiovascular Issues in Pregnancy
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