自发性冠状动脉夹层及其相关诱发因素：一项叙述性综述。

Janssen E B N J, de Leeuw P W, Maas A H E M

Radboud University, Nijmegen, The Netherlands.

Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.

Neth Heart J. 2019 May;27(5):246-251. doi: 10.1007/s12471-019-1235-4.

Spontaneous coronary artery dissection (SCAD) represents around 25% of cases of acute coronary syndromes (ACS) in women aged 40-65 years who have few or no traditional cardiovascular risk factors. It is assumed that the incidence is underestimated, as the angiographic appearance of SCAD may often mimic atherosclerosis. This review aims to examine SCAD by focusing on the associated predisposing factors and precipitating stressors in this heterogeneous patient population, as well as the best treatment approach and the prognosis. Progressive knowledge has improved our current understanding of SCAD, but more awareness among clinicians is necessary. Recently, two position papers from the European Society of Cardiology (ESC) and the American Heart Association (AHA) have been released, which will be summarised in brief.

自发性冠状动脉夹层（SCAD）约占40 - 65岁女性急性冠状动脉综合征（ACS）病例的25%，这些女性几乎没有或没有传统的心血管危险因素。由于SCAD的血管造影表现常可模仿动脉粥样硬化，故推测其发病率被低估。本综述旨在通过关注这一异质性患者群体中的相关易感因素和诱发应激源，以及最佳治疗方法和预后，来研究SCAD。不断积累的知识增进了我们目前对SCAD的理解，但临床医生仍需提高认识。最近，欧洲心脏病学会（ESC）和美国心脏协会（AHA）发布了两篇立场文件，将对其进行简要总结。