Idiopathic spontaneous coronary artery dissection: incidence, diagnosis and treatment

摘要: Abstract Background Less is known about characteristics, treatment and follow-up of patients with spontaneous coronary artery dissection (SCAD) without associated pregnancy or underlying atherosclerosis. Methods We reviewed 5054 consecutive angiographies for SCAD in atherosclerosis performed angiography eligible patients. Results were assessed five (mean age 44±8.7 years). Interestingly, all premenopausal women. Three had no cardiovascular risk factors, whereas two previous smokers one slightly elevated cholesterol levels. Clinical presentation was acute myocardial infarction four cases unstable angina pectoris them. Dissection localized the left anterior descending (LAD) three first marginal branch circumflex cases. treated conservatively antithrombotic therapy beta-blocker, patient rescue-PCI stenting ostium LAD after failed thrombolysis. The fifth woman dissected proximal underwent CABG. Follow-up 5.9±4.4 months showed complete angiographic resolution medically a perfect result stented LAD. All free symptoms mean 13±10 months. Conclusions Idiopathic rare cause syndrome In case single vessel normal blood flow vessel, medical aspirin, clopidogrel beta-blockade leads to within few