Di Marco Massimo, Clemente Daniela, Forlani Daniele, D'Alleva Alberto, Duronio Gino, Paloscia Leonardo
CCU-Interventional Cardiology, Santo Spirito Hospital, Pescara, Italy.
Cardiology Unit, University of L'Aquila, Italy.
J Cardiol Cases. 2016 May 26;14(2):59-61. doi: 10.1016/j.jccase.2016.04.003. eCollection 2016 Aug.
Spontaneous coronary artery dissection (SCAD) is a rare disease associated with high mortality rate, whose etiology and pathogenesis has been poorly understood to date. The management of these patients is still controversial. A young, otherwise healthy woman, without known underlying conditions leading to SCAD, was admitted to our Intensive Cardiology Care Unit; she had history of intense psychological stress. She was managed with a conservative approach based on watchful waiting and medical therapy. She had an uneventful course. This is a rare case of SCAD where stable hemodynamics allowed us to adopt a conservative approach. < Spontaneous coronary artery dissection (SCAD) is a rare disease associated with high mortality rate, whose etiology and pathogenesis has been poorly understood to date. The management of spontaneous coronary artery dissection (SCAD) is still debated due to the rarity of cases; to treat or not to treat invasively? In our case, the hemodynamic stability of the patient suggested to wait and watch with serial angiographies and medical therapy. The uneventful course ruled in favor of our choice. Thus, the take home message is that not all cases of SCAD deserve to be treated with invasive procedures.>.
自发性冠状动脉夹层(SCAD)是一种死亡率较高的罕见疾病,其病因和发病机制至今仍未完全明确。对这类患者的治疗仍存在争议。一名年轻、无其他基础疾病导致SCAD且身体健康的女性被收入我们的心脏重症监护病房;她有强烈心理应激史。我们对她采取了基于密切观察和药物治疗的保守治疗方法。她病程顺利。这是一例罕见的SCAD病例,稳定的血流动力学状况使我们能够采取保守治疗方法。<自发性冠状动脉夹层(SCAD)是一种死亡率较高的罕见疾病,其病因和发病机制至今仍未完全明确。由于病例罕见,自发性冠状动脉夹层(SCAD)的治疗仍存在争议;是否进行侵入性治疗?在我们的病例中,患者的血流动力学稳定性表明应通过连续血管造影和药物治疗进行观察。顺利的病程证明我们的选择是正确的。因此,关键信息是并非所有SCAD病例都值得进行侵入性治疗。>