SCAD Flashcards
1
Q
describe the clinical presentation of SCAD
A
- Asymptomatic to usntable angina
- Acute MI
- ventricular arrhythmias
- sudden cardiac death
- asymptomatic and discovered on angiogram
2
Q
describe the diagnosis of SCAD by coronary angriography
A
- Presence of a thin longitudinal radiolucent line representing intimal medial flap with flow in 2 or more lumens
- narrowing cause by the intramural hematoma imaging on the lumen can be misinterpreted as an atherosclerotic stenosis
- In the setting of YOUNG WOMEN presenting with ACS on angio and NO CAD risk factors SCAD should be suspected and IVUS or OCT should be done
3
Q
describe the typical patient of SCAD
A
- young patient
- low coronary risk profile
- FEMALE sex
- POST-PARTUM
- Present with unstable angina
- Non-ST elevation MI
- ST elevation MI
4
Q
define spontaneous coronary artery dissection (SCAD
A
- separation of the media by hemorrhage with or without an assocaited intimal tear and isnt associated with aortic root disection nor is it a consequence of coronary angioplasty or angiography, cardiac surgery or chest trauma
- common in women, can cause ACS and sudden death
- 2/3 occur during pregnancy or in the postpartum period
5
Q
what is the most common vessel for SCAD to occur
A
- Left anterior descending coronary artery
- multivessel dissection is present in 20% of the cases
6
Q
describe the diagnosis of SCAD
A
- early coronay angiography remains essential in the diagnosis
- IVUS and OCT imaging provide detailed information on the location and extent of the dissection
7
Q
how to treat SCAD
A
- pts with ongoing myocardial ischemia must be treated with early revascularization (PCI or CABG)
- Pts with out flow limiting dissection should be treated conservatively as spontaenous healing is possible
