University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL USA.
Curr Probl Cardiol. 2024 Oct;49(10):102758. doi: 10.1016/j.cpcardiol.2024.102758. Epub 2024 Jul 25.
Spontaneous coronary artery dissection (SCAD) is the nonatherosclerotic, nontraumatic dissection of an epicardial coronary artery which is predominantly caused by intramural hematoma formation or intimal disruption. SCAD is an increasingly recognized cause of acute coronary syndrome (ACS) in young women and its true prevalence may be underestimated due to its underdiagnosis. The pathogenesis of SCAD is multifaceted and influenced by gender-specific factors, hormonal fluctuations, genetics, arteriopathies, and physical and emotional stressors. Although the pathogenesis of SCAD is multifaceted, current guidance on the care of the post-SCAD patient is limited. Moreover, it is necessary to address each of the different components contributing to the pathogenesis of SCAD in order to improve outcomes and quality of life in this patient population. This literature review aims to consolidate the current knowledge on the medical management, rehabilitation, reproductive and mental health care, and comorbidities that affect SCAD survivors.
自发性冠状动脉夹层(SCAD)是心外膜冠状动脉的非动脉粥样硬化性、非外伤性夹层,主要由壁内血肿形成或内膜破裂引起。SCAD 是年轻女性急性冠状动脉综合征(ACS)的一个日益被认识的原因,由于诊断不足,其真实患病率可能被低估。SCAD 的发病机制是多方面的,受性别特异性因素、激素波动、遗传、血管病变以及身体和情绪应激源的影响。尽管 SCAD 的发病机制是多方面的,但目前关于 SCAD 患者护理的指南有限。此外,有必要解决导致 SCAD 发病机制的每个不同因素,以改善这一患者群体的预后和生活质量。本文献综述旨在整合关于 SCAD 幸存者的医学管理、康复、生殖和心理健康护理以及合并症的现有知识。