Division of Cardiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Division of Cardiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Prog Cardiovasc Dis. 2018 Mar-Apr;60(6):629-634. doi: 10.1016/j.pcad.2018.04.001. Epub 2018 Apr 6.
Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome (ACS) in young women who otherwise do not have traditional risk factors for coronary artery disease. Though previously considered to be a rare occurrence and primarily associated with pregnancy, contemporary series have demonstrated that SCAD may account for 35% of ACS in women under the age of 50 years, and peripartum SCAD accounts for the minority of cases. Importantly, an association between SCAD and arterial abnormalities in non-coronary arterial distributions has been described. The most common of these arterial abnormalities is fibromuscular dysplasia. This manuscript will briefly review the epidemiology, diagnosis, and treatment of SCAD and provide an overview of how SCAD may be a cardiac manifestation of an underlying vascular disease in the majority of patients.
自发性冠状动脉夹层（SCAD）是一种越来越被认可的急性冠状动脉综合征（ACS）的病因，发生于无传统冠状动脉疾病危险因素的年轻女性。尽管先前认为 SCAD 是一种罕见的疾病，主要与妊娠相关，但当代研究表明，SCAD 可能占 50 岁以下女性 ACS 的 35%，而围产期 SCAD 占少数病例。重要的是，SCAD 与非冠状动脉分布的动脉异常之间存在关联。这些动脉异常中最常见的是纤维肌性发育不良。本文将简要回顾 SCAD 的流行病学、诊断和治疗，并概述 SCAD 如何在大多数患者中成为潜在血管疾病的心脏表现。
