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• W2161914854 abstract "Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS). Its incidence, etiology and pathophysiology are still unknown. The series of cases published to date allow us to state that it is a clinical entity that predominantly affects young women in the peripartum period (25% of cases in the third trimester of pregnancy or immediate postpartum period), with an estimated incidence of around 0.1% of coronary arteriographies performed for SCAD [ 1 Maeder M. Ammann P. Angehrn W. Rickli H. Idiopathic spontaneous coronary artery dissection: incidence, diagnosis and treatment. Int J Cardiol. 2005; 101: 363-369 Abstract Full Text Full Text PDF PubMed Scopus (146) Google Scholar , 2 Basso C. Morgagni G.L. Thiene G. Spontaneous coronary artery dissection: a neglected cause of acute myocardial ischemia and sudden death. Heart. 1996; 75: 451-454 Crossref PubMed Scopus (198) Google Scholar , 3 De Maio S.J. Kinsella S.H. Silvermann M.E. Clinical course and long-term prognosis of spontaneous coronary artery dissection. Am J Cardiol. 1989; 64: 471-474 Abstract Full Text PDF PubMed Scopus (338) Google Scholar ]. This incidence is underestimated because diagnosis of SCAD is often made after sudden death occurring in a young person [ [4] Mulvany N.J. Ranson D.L. Pilbeam M.C. Isolated dissection of the coronary artery: a post-mortem study of seven cases. Pathology. 2001; : 307-311 PubMed Google Scholar ]. The altered hormonal balances occurring in pregnancy and the postpartum period appear to favor weakening of the arterial walls and predispose them to rupture. SCAD has thus been associated with the use of oral contraceptives. In a review of the literature Evangelou et al. found 5 cases of SCAD in middle-age women with oral contraceptive use [ [5] Evangelou D. Letsas K.P. Korantzopoulos P. Antonellis I. Sioras E. Kardaras F. Spontaneous coronary artery dissection associated with oral contraceptive use: a case report and review of the literature. Int J Cardiol. Oct 10 2006; 112: 380-382 Abstract Full Text Full Text PDF PubMed Scopus (44) Google Scholar ]. However, cases have also been reported associated with cocaine use or intense physical exercise, as well as others classified as idiopathic due to the lack of any apparent triggering factor. The most frequently involved artery in women is the left anterior descending coronary artery (LAD), whereas in men the affected artery is predominantly the right coronary artery (RCA) [ [3] De Maio S.J. Kinsella S.H. Silvermann M.E. Clinical course and long-term prognosis of spontaneous coronary artery dissection. Am J Cardiol. 1989; 64: 471-474 Abstract Full Text PDF PubMed Scopus (338) Google Scholar ]. Cases of multivessel or left main coronary artery (LMCA) involvement are also more frequent in women." @default.
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• W2161914854 date "2009-03-01" @default.
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• W2161914854 title "Idiopathic spontaneous coronary artery dissection. Clinical and pathological correlate" @default.
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• W2161914854 doi "https://doi.org/10.1016/j.ijcard.2007.08.081" @default.
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