Ullah Waqas, Ali Zain, Khanal Shristi, Khan Mariya, Gajanan Ganesh, Sattar Yasar, Mukhtar Maryam, FIgueredo Vincent
Internal Medicine, Abington Hospital-Jefferson Health, Abington, USA.
Internal Medicine, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK.
Cureus. 2019 Jul 24;11(7):e5231. doi: 10.7759/cureus.5231.
Spontaneous coronary artery dissection (SCAD) is a life-threatening condition and multiple conditions have been associated with this entity. This study aims to further investigate and characterize the association of the underlying rheumatological disease with SCAD. A comprehensive literature search on four databases was performed using different Medical Subject Headings (MeSH) and all articles on SCAD in association with rheumatological diseases were identified. The analysis was performed using the Statistical Package for Social Sciences (SPSS), v22 (IBM SPSS Statistics, Armonk, NY). Ten articles of SCAD secondary to rheumatological reasons were identified. The majority of presentations were associated with systemic lupus erythematosus (SLE). Most patients presented with a non-ST-elevation myocardial infarction (NSTEMI) involving the left main coronary vessel. The majority of them were successfully managed with stenting. Mortality was less than 20% with prompt identification and management of the SCAD. SLE was the most commonly reported rheumatological condition associated with SCAD. Prompt diagnosis and management of SCAD in such patients can be life-saving.
自发性冠状动脉夹层(SCAD)是一种危及生命的疾病,多种情况与该疾病相关。本研究旨在进一步调查并描述潜在风湿性疾病与SCAD之间的关联。使用不同的医学主题词(MeSH)在四个数据库上进行了全面的文献检索,并识别了所有与风湿性疾病相关的SCAD文章。使用社会科学统计软件包(SPSS)v22(IBM SPSS Statistics,纽约州阿蒙克)进行分析。确定了10篇继发于风湿性原因的SCAD文章。大多数病例与系统性红斑狼疮(SLE)相关。大多数患者表现为累及左主干冠状动脉的非ST段抬高型心肌梗死(NSTEMI)。其中大多数通过支架置入成功治疗。及时识别和处理SCAD,死亡率低于20%。SLE是与SCAD相关最常报道的风湿性疾病。对此类患者及时诊断和处理SCAD可挽救生命。