Pender Patrick, Zaheen Mithila, Dang Quan M, Dang Viet, Xu James, Hollings Matthew, Lo Sidney, Negishi Kazuaki, Zaman Sarah
Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia.
Department of Cardiology, Liverpool Hospital, Sydney, NSW 2170, Australia.
Medicina (Kaunas). 2025 Apr 1;61(4):650. doi: 10.3390/medicina61040650.
Spontaneous coronary artery dissection (SCAD) is an uncommon but significant cause of acute coronary syndrome (ACS), predominantly affecting younger women without traditional cardiovascular risk factors. SCAD is defined as a non-atherosclerotic, non-traumatic dissection of the coronary artery, leading to the formation of an intramural haematoma or intimal tear causing obstruction to blood flow and myocardial ischaemia. Unlike traditional atherosclerotic coronary artery disease, SCAD has unique pathophysiological mechanisms. SCAD is thought to arise secondary to a bleed and/or dissection within the arterial wall, linked to hormonal influences with potential triggers of physical or emotional stress and predisposition such as an underlying connective tissue disorder. Despite being increasingly recognised, SCAD remains underdiagnosed, and knowledge regarding SCAD epidemiology is limited. In addition, the impact of SCAD extends beyond the immediate cardiac event, encompassing psychological distress, the need for rehabilitation, and long-term surveillance. This has implications not just for the patient but also their family and the healthcare system. This narrative review summarises the current knowledge of SCAD epidemiology, including the affected population, its associated risk factors, and healthcare impact. By identifying current gaps in knowledge, this review aims to encourage targeted research, public awareness, and policy initiatives to improve outcomes for individuals affected by SCAD.
自发性冠状动脉夹层（SCAD）是急性冠状动脉综合征（ACS）的一种罕见但重要的病因，主要影响没有传统心血管危险因素的年轻女性。SCAD被定义为冠状动脉的非动脉粥样硬化性、非创伤性夹层，导致壁内血肿形成或内膜撕裂，引起血流阻塞和心肌缺血。与传统的动脉粥样硬化性冠状动脉疾病不同，SCAD具有独特的病理生理机制。SCAD被认为继发于动脉壁内的出血和/或夹层，与激素影响有关，潜在触发因素包括身体或情绪应激以及诸如潜在结缔组织疾病等易患因素。尽管SCAD越来越受到认可，但仍存在诊断不足的情况，关于SCAD流行病学的知识也有限。此外，SCAD的影响不仅限于即时心脏事件，还包括心理困扰、康复需求和长期监测。这不仅对患者有影响，对其家庭和医疗系统也有影响。本叙述性综述总结了SCAD流行病学的当前知识，包括受影响人群、相关危险因素和医疗影响。通过识别当前知识空白，本综述旨在鼓励有针对性的研究、公众意识提高和政策倡议，以改善受SCAD影响个体的结局。
