Ver el código de «Coronary artery dissection»

==Background==
[[File:RevisedSCAD.png|thumb|Illustration showing coronary artery dissection with formation of a hematoma (purple) within the walls of the coronary artery.]]
*Spontaneous tear in the intimal wall of a coronary artery leading to a false lumen and intramural hematoma, similar to [[aortic dissection]]
*Much more common in young women

===Causes===
*Hormonal changes in vessel wall (eg pregnancy, contraceptives)
*Shear forces
*Fibromuscular dysplasia
*Underling [[connective tissue disorder]]
*Iatrogenic (during coronary angiography)

==Clinical Features==
*[[Chest pain|Chest]] or shoulder pain
*[[Syncope]]
*[[Dyspnea]]
*Diaphoresis
*[[Nausea]]

==Differential Diagnosis==
{{ST elevation DDX}}

==Evaluation==
[[File:PMC3424780 HV-13-53-g003.png|thumb|ECG showing ST elevation in the antero-lateral leads in a patient with coronary artery dissection.]]
===Workup===
*[[EKG]]
**Usually presents as an Anterior MI with ST changes in anterior Precordial leads (V1-V3)
*Basic labs, including [[troponin]]
*[[Echocardiography]]

===Diagnosis===
*[[EKG]] usually shows an Anterior MI with ST changes in anterior Precordial leads (V1-V3)
*[[Troponin]] may be elevated
*Definitive diagnosis made at time of coronary angiography

==Management==
*[[Aspirin]], [[beta-blockers|β-blocker]], and 1 year of [[clopidogrel]]<ref>Saw J, Aymong E, Sedlak T, et al. Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes. Circ Cardiovasc Interv 2014; 7:645.</ref>
*Cardiology consultation
**PCI can be challenging given vessel wall fragility

==Disposition==
*Admit

==See Also==
*[[Chest Pain]]
*[[ST-segment_elevation_myocardial_infarction_(STEMI)|STEMI]]

==External Links==
*[https://rebelem.com/spontaneous-coronary-artery-dissection-scad/ Rebel EM - Spontaneous Coronary Artery Dissection] 

==References==
<references/>

[[Category:Cardiology]]