Division of Cardiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
Division of Cardiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
J Am Coll Cardiol. 2016 Jul 19;68(3):297-312. doi: 10.1016/j.jacc.2016.05.034.
Spontaneous coronary artery dissection (SCAD) is gaining recognition as an important cause of myocardial infarction, especially in young women. There has been a surge in the diagnosis of SCAD in recent years, presumably due to an increased use of coronary angiography, and the clinical availability and application of high-resolution intracoronary imaging. The improved recognition and diagnosis, together with increased publications and attention through social media, have considerably raised awareness of this condition, which was once believed to be very rare. Recent publications of moderate to large contemporary case series have helped elucidate the early natural history, presenting characteristics (clinical and angiographic), underlying etiology, management, and cardiovascular outcomes with this condition, thus providing observations and important clinical insights of value to clinicians managing this challenging and perplexing patient cohort. The aim of our review is to provide a comprehensive contemporary update of SCAD to aid health care professionals in managing these patients in both the acute and chronic settings.
自发性冠状动脉夹层 (SCAD) 作为心肌梗死的一个重要病因，尤其在年轻女性中，正逐渐受到重视。近年来，SCAD 的诊断率飙升，推测可能是由于冠状动脉造影的广泛应用，以及高分辨率冠状动脉内影像学的临床可用性和应用。由于对该病的认识和诊断水平提高，以及通过社交媒体发布的研究和关注增多，人们对该病的认识有了很大提高，因为该病曾被认为非常罕见。最近发表的中等至大型当代病例系列研究有助于阐明该病的早期自然史、临床表现（临床和血管造影）、潜在病因、治疗方法和心血管结局，从而为管理这些具有挑战性和令人困惑的患者群体的临床医生提供观察结果和重要的临床见解。我们的综述旨在提供 SCAD 的全面当代更新，以帮助医疗保健专业人员在急性和慢性环境中管理这些患者。
