29 - Spontaneous Coronary Artery Dissection

Question 1

definition of spontaneous coronary artery dissection SCAD

Answer 1

separation of the media by hemorrhage w/o an associated intimal tear and isn’t a/w aortic root dissection nor is it a consequence of coronary angioplast or angiography, cardiac surgery or chest trauma

Question 2

____ occur durign pregnancy or in the postpartum period

Answer 2

2/3

Question 3

most common pathologies associated with SCAD

Answer 3

• coronary atherosclerosis and vascular changes occurring during the peripartum period
• connective tissue disorders such as SLE or vasculaitis
• cocaine abuse
• vigourous exercise and prolonged sneezing
• idiopathic

Question 4

SCAD on intracoronary imaging

Answer 4

presence of thin longitudinal radiolucent line representing intimal medial flap with flow in 2 or more lumens

Question 5

occurs most often in _______ and occurs frequently in _____-

Answer 5

young women

Question 6

most freqently involved vessel

Answer 6

LAD

Question 7

essential diagnostic tool for SCAD

Answer 7

early coronary angiography

Question 8

tools that provide detailed information on the location and extent of the dissection

Answer 8

Intravascular ultrasound IVUS and optical coherence tomography OCT

Question 9

Pts with ongoing MI must be treated with ______-.

Pts w/o flow limiting dissection should be treated _________.

Answer 9

–> early revalsularization with PCI or CABG

–> conservatively as spontaneous healing is possible