U.O.C. Cardiologia Clinica e Riabilitativa, San Filippo Neri Hospital, ASL Roma 1, via Martinotti 20, 00135 Rome, Italy.
U.O.C. Cardiologia, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy.
Trends Cardiovasc Med. 2022 Feb;32(2):92-100. doi: 10.1016/j.tcm.2021.01.002. Epub 2021 Jan 14.
The growing use of imaging examinations has led to increased detection of spontaneous coronary artery dissection (SCAD) as a non-atherosclerotic cause of acute coronary syndrome (ACS). Since a greater awareness of pathophysiologic mechanisms has relevant implications in clinical practice, we aim to provide an update to current knowledge of SCAD pathophysiology. We discuss the most common conditions associated with SCAD, including predisposing factors and triggers, and focus on potential mechanisms leading to SCAD development. Furthermore, we report the main genetic research findings that have shed further light on SCAD pathophysiology. Finally, we summarize practical considerations in SCAD management based on pathophysiologic insights.
成像检查的广泛应用导致自发性冠状动脉夹层（SCAD）作为急性冠状动脉综合征（ACS）的非动脉粥样硬化性病因的检出率增加。由于对病理生理机制的认识提高与临床实践具有相关性，因此我们旨在提供 SCAD 病理生理学的最新知识更新。我们讨论了与 SCAD 相关的最常见情况，包括易患因素和诱因，并重点介绍了导致 SCAD 发展的潜在机制。此外，我们报告了主要的遗传研究结果，这些结果进一步阐明了 SCAD 的病理生理学。最后，我们根据病理生理学的认识总结了 SCAD 管理中的实用注意事项。
