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spontaneous coronary dissection

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https://www.readbyqxmd.com/read/28529093/revascularization-methods-in-spontaneous-coronary-artery-dissection-a-focused-review
#1
REVIEW
Regina Lee, Itsik Ben-Dor
Spontaneous coronary artery dissection (SCAD) is becoming widely recognized as an important cause of myocardial infarction, particularly in younger women. Tendency toward conservative management has been primarily based on observational data. Intervention is recommended when coronary blood flow is compromised and high risk features such as left main involvement, ongoing ischemia, or hemodynamic or electrical instability are present. Unlike the atherosclerotic process where the superiority of stenting compared with plain old balloon angioplasty has been established in the acute setting, randomized studies for revascularization strategies for spontaneous coronary dissection are currently lacking...
May 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28516101/early-spontaneous-resolution-of-an-iatrogenic-acute-type-a-aortic-dissection
#2
Mohammad A Zafar, Philip Y K Pang, Glen A Henry, Bulat A Ziganshin, Maryann Tranquilli, John A Elefteriades
Acute aortic dissection is a rare but devastating complication during cardiac catheterization. We present the case of an elderly female who incurred a Stanford Type A/DeBakey Type I acute aortic dissection extending into the arch vessels and descending aorta likely occurring during right coronary artery engagement for angioplasty. The patient was treated successfully by immediately sealing the entrance of the dissection via the placement of a stent and anti-impulse therapy. Follow-up computed tomography scan showed complete resolution of the dissection within one month...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28516099/conservative-management-of-extensive-iatrogenic-aortic-dissection
#3
Derrick Y Tam, Amine Mazine, Asim N Cheema, Bobby Yanagawa
Iatrogenic aortic dissection (IAD) is a rare complication of percutaneous coronary interventions (PCI). There are no clear guidelines for IAD management, and limited data are available. Registry data and case series combined with extrapolations from our experience with spontaneous Type-A dissections suggest that very limited dissections are often managed conservatively with coronary stenting of the entry tear when possible, while more extensive dissections are managed surgically. We present a case report of a 50-year-old woman who underwent PCI for an ST-elevation myocardial infarction that resulted in an extensive IAD from the ostium of the right coronary artery to the aortic root, ascending aorta, and aortic arch...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28516098/spontaneous-regression-of-a-large-iatrogenic-dissection-of-the-ascending-aorta
#4
Aurélien Roumy, Matthias Kirsch, René Prêtre, Lars Niclauss
A 74-year-old woman was admitted for right coronary angioplasty. During the procedure, she complained about chest pain, and contrast injection showed an iatrogenic dissection of the ascending aorta. A contrast computed tomography (CT) scan confirmed the diagnosis via visualization of a large non-circulating false lumen, which involved nearly the entire ascending aorta. The patient remained hemodynamically stable and asymptomatic while receiving medical therapy alone. Another CT scan performed 3 days later showed complete regression of the false lumen...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28509893/spontaneous-coronary-artery-dissection-insights-from-histology-and-optical-coherence-tomography
#5
Sandeep K Krishnan, Alex Zhu, Brent Larson, Timothy D Henry, Suhail Dohad
Spontaneous coronary artery dissection (SCAD) is a well-known but infrequent cause of acute coronary syndrome (ACS), and often goes unrecognized. Although management of SCAD is, at times, controversial, when a patient presents with ACS, percutaneous coronary intervention (PCI) is frequently necessary. We present a patient with ST-segment elevation myocardial infarction (STEMI) with SCAD that illustrates two important points: use of intracoronary optical coherence tomography to guide PCI, and histologic assessment to provide a unique insight into the etiology of SCAD...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28509891/spontaneous-coronary-artery-dissection-a-review-of-pathogenesis-presentations-treatment-and-outcomes
#6
Aasim Afzal, Syed Sarmast, James W Choi, Peter A McCullough, Jeffrey M Schussler
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndromes and sudden cardiac death. The epidemiology, pathogenesis, and optimal approaches to diagnosis and management are poorly understood. Additionally, SCAD as a syndrome is commonly under-recognized and its prognosis is not well studied. Guidelines on management of SCAD have not yet been established. We present three cases of SCAD that varied in their clinical presentation and describe the different management strategies utilized...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28504113/prognosis-of-spontaneous-coronary-artery-dissection-treated-by-percutaneous-coronary-intervention-with-optical-coherence-tomography
#7
Tsuyoshi Nishiguchi, Atsushi Tanaka, Akira Taruya, Yuichi Ozaki, Mai Nakai, Ikuko Teraguchi, Shingo Ota, Akio Kuroi, Takeyoshi Kameyama, Takashi Yamano, Tomoyuki Yamaguchi, Yoshiki Matsuo, Yasushi Ino, Takashi Kubo, Takeshi Hozumi, Takashi Akasaka
BACKGROUND: Although about half of patients with spontaneous coronary artery dissection (SCAD) face ongoing necrosis, conservative therapy is recommended due to a high complication rate in angiography-guided percutaneous coronary intervention (PCI). The aim of this study was to investigate clinical outcomes of SCAD treated by optical coherence tomography (OCT)-guided PCI. METHODS: This study consisted of consecutive 306 patients with acute coronary syndrome (ACS) who underwent OCT-guided PCI...
May 11, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28461002/use-of-a-three-stent-technique-for-a-case-of-spontaneous-coronary-artery-dissection
#8
Alexander M Dashwood, Jacqueline Saw, Priyanka Dhillon, Dale Murdoch
A 78-year-old woman presented with acute inferior ST-segment-elevation myocardial infarction and complete heart block. Angiography revealed spontaneous coronary artery dissection (SCAD) of her right coronary artery. Given her ongoing instability, we proceeded to primary coronary intervention. A strategy of sealing the distal lesion edge followed by the proximal edge containing the intramural hematoma before placing a final stent to the midsegment was decided on (3-stent strategy). Our case represents the second such "sequential stent-sandwiching" report and provides a strategy for percutaneous coronary intervention in hemodynamically unstable patients with SCAD...
February 24, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28452228/medical-treatment-or-revascularisation-as-the-best-approach-for-spontaneous-coronary-artery-dissection-a-systematic-review-and-meta-analysis
#9
José Luís Martins, Vera Afreixo, Luís Santos, Marco Costa, José Santos, Lino Gonçalves
INTRODUCTION: Patients presenting with spontaneous coronary artery dissection (SCAD) may receive either conservative medical management or a revascularisation strategy. There is still a lack of consensus with respect to the best treatment approach for SCAD. OBJECTIVES: We sought to determine whether outcomes differ between the first-line treatment approaches (conservative versus revascularisation) in patients with SCAD. METHODS: We searched Medline, EMBASE and the Cochrane Library for studies published from January 1990 to November 2016 that compared first-line treatments for patients with SCAD...
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28449426/-a-case-of-intramural-hematoma-of-the-esophagus-mimicking-acute-coronary-syndrome
#10
Dae Gon Ryu, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Dong Il Jeong, Wan Chul Kim, Jae Gyu Shin, Tae Won Lim
Intramural hematoma of the esophagus is a rare condition that can be spontaneous or secondary to trauma, toxic ingestion, or intervention. If it is the spontaneous type, it usually presents initially with epigastric pain, hematemesis or dysphagia. We present a case of intramural hematoma of the esophagus mimicking acute coronary syndrome. A 63-year-old man presented with severe acute chest pain. He has four coronary stents that were inserted five years ago, from a different hospital, and is on dual antiplatelet agents...
April 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28437245/long-term-outcome-of-a-spontaneous-coronary-artery-dissection-treated-with-a-bioresorbable-scaffold
#11
Nieves Gonzalo, Fernando Macaya, José J Gómez de Diego, Javier Escaned
No abstract text is available yet for this article.
April 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28433960/multiple-spontaneous-intimal-dissections-with-single-left-coronary-artery-and-coronary-artery-aneurysm
#12
Guy Achkouty, Patrick Henry, Jean-Guillaume Dillinger
No abstract text is available yet for this article.
April 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28429664/alternative-causes-of-myocardial-ischemia-in-women-an-update-on-spontaneous-coronary-artery-dissection-vasospastic-angina-and-coronary-microvascular-dysfunction
#13
Bina Ahmed, Mark A Creager
Although coronary obstruction due to atherosclerosis is the most common cause of myocardial ischemia, a significant proportion of patients have myocardial ischemia in the absence of obstructive epicardial coronary artery disease (CAD). This finding is more common among women and alternative causes can mediate myocardial ischemia. Abnormalities in vascular structure, alterations in coronary vasomotion and dysfunction of the coronary microcirculation can all cause ischemia in the absence of obstructive CAD due to atherosclerosis...
April 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28421589/spontaneous-coronary-dissection-optical-coherence-tomography-insights-before-and-after-stenting
#14
Calin Homorodean, Mihail Spinu, Mihai Claudiu Ober, Maria Olinic, Dan Mircea Olinic
No abstract text is available yet for this article.
2017: Cardiology Journal
https://www.readbyqxmd.com/read/28412719/combined-measurement-of-factor-xiii-and-d-dimer-is-helpful-for-differential-diagnosis-in-patients-with-suspected-pulmonary-embolism
#15
Ning Tang, Ziyong Sun, Dengju Li, Jun Yang, Shiyu Yin, Qing Guan
BACKGROUND: D-dimer has been used to rule out pulmonary embolism (PE). Based on previous reports of decreased concentrations of coagulation factor XIII (FXIII) in venous thromboembolism, and no change in FXIII concentration in patients with acute cardiovascular disease, we evaluated the benefit of simultaneously measuring D-dimer and FXIII concentrations for diagnosing PE. METHODS: In this prospective single-center study, we enrolled 209 patients initially suspected of having PE, and measured their D-dimer and FXIII concentrations...
April 17, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28412257/complete-healing-of-spontaneous-coronary-artery-dissection-demonstrated-by-optical-coherence-tomography-in-a-young-postpartum-female-presenting-with-acute-coronary-syndrome
#16
Periklis Davlouros, Ioanna Xanthopoulou, Grigorios Tsigkas, Virginia Mplani, Stefanos Despotopoulos, George Hahalis
No abstract text is available yet for this article.
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28398579/optical-coherence-tomography-for-strategy-planning-and-staged-optimization-of-spontaneous-coronary-artery-dissection
#17
Enrico Fabris, Mark W Kennedy, Gianfranco Sinagra, Arnoud Van't Hof, Elvin Kedhi
No abstract text is available yet for this article.
April 6, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28398396/-bioresorbable-vascular-scaffolds-clinical-experience-of-the-emilia-romagna-region-italy
#18
Alberto Menozzi, Gianluca Calogero Campo, Vincenzo Guiducci, Gianni Dall'Ara, Andrea Santarelli, Paolo Sbarzaglia, Marco Balducelli, Paolo Magnavacchi, Fabio Sgura, Luciano Losi, Luigi Vignali, Gianni Casella, Luigi Steffanon, Fabio Tarantino, Francesco Saia
BACKGROUND: The bioresorbable vascular scaffold (BRS) technology constitutes the new revolution of the coronary artery disease interventional treatment. Currently, three distinct types of BRSs are available but only one, the Absorb BVS, was on the market in 2013 when the Regional Commission for Medical Devices and the Cardiology and Cardiac Surgery Commission of the Emilia-Romagna Region drew up a technical and scientific essay to provide guidance for the introduction of BRS in public and affiliated health facilities...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28396082/pregnancy-related-spontaneous-coronary-artery-dissection-a%C3%A2-case-series-and-literature-review
#19
Emily Rose, Maheedhar Gedela, Nathan Miller, Paul L Carpenter
BACKGROUND: Cardiac emergencies during pregnancy are rare but have significant associated morbidity and mortality when they do occur. The emergency physician must not only be aware of potentially life-threatening conditions in the pregnant woman, but also know the emergent management and treatment of these conditions to avoid worsening of the underlying condition. Pregnancy-related spontaneous coronary artery dissection has been described in the cardiology literature, but is not well-known in emergency medicine literature...
April 7, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28383849/-myocardial-infarction-on-spontaneous-coronary-dissection-caused-by-fibromuscular-dysplasia
#20
L Jackers, L Davin, B Falque, M Magnée, L Piérard
Spontaneous Coronary Artery Dissection (SCAD) is a non-traumatic and non-iatrogenic separation of the coronary arterial wall. Although uncommon, it should be suspected in any young patient with acute myocardial infarction especially without risk factor of cardiovascular disease. Early coronary angiography is essential in the diagnosis of SCAD. Fibromuscular dysplasia is a rare cause of SCAD, particularly encountered in young women. This is a nonatherosclerotic and noninflammatory vascular disease. Fibromuscular dysplasia may cause stenosis, aneurysm, dissection and / or occlusion of arteries...
October 2016: Revue Médicale de Liège
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