Spontaneous coronary artery dissection treatment approach: Difference between revisions

	Spontaneous Coronary Artery Dissection Microchapters
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Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Spontaneous coronary artery dissection from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Approach
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Angiography
CT
MRI
Echocardiography
Other Imaging Findings
Other Diagnostic Studies
Treatment
Treatment Approach
Medical Therapy
Percutaneous Coronary Intervention
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Type 1 Case 1; Case 2; Case 3; Case 4; Case 5; Case 6; Case 7; Type 2A Case 1; Case 2; Case 3; Case 4; Case 5; Case 6; Type 2B Case 1; Case 2; Case 3; Case 4; Type 3 Case 1; Case 2; Case 3; Case 4; Case 5; Case 6;

Revision as of 22:23, 26 February 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A.

Synonyms and keywords: SCAD

Algorithm for management of acute spontaneous coronary artery dissection.^[1]

Management of Acute Spontaneous Coronary Artery Dissection

Clinically stable without high-risk anatomy
(i.e., left main or proximal 2-vessel coronary artery dissection)

Clinically stable
with left main or severe proximal 2-vessel dissection

Active/ongoing ischemia
or hemodynamic instability

❑ Conservative therapy
❑ Monitor as inpatient 3–5 days

❑ Consider CABG
❑ Conservative Rx may be reasonable

❑ Consider PCI if feasible, OR
❑ Urgent CABG (based on technical considerations and local expertise

Abbreviations: CABG, coronary artery bypass grafting; PCI, percutaneous coronary intervention; Rx, management.

↑ Hayes, Sharonne N.; Kim, Esther S.H.; Saw, Jacqueline; Adlam, David; Arslanian-Engoren, Cynthia; Economy, Katherine E.; Ganesh, Santhi K.; Gulati, Rajiv; Lindsay, Mark E.; Mieres, Jennifer H.; Naderi, Sahar; Shah, Svati; Thaler, David E.; Tweet, Marysia S.; Wood, Malissa J. (2018). "Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association". Circulation: CIR.0000000000000564. doi:10.1161/CIR.0000000000000564. ISSN 0009-7322.

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 {{Familytree | | | |,|-|-|-|-|-|+|-|-|-|-|-|.| | | |}}
 {{Familytree | | | B01 | | | | B02 | | | | B03 | | |B01='''Clinically stable without high-risk anatomy'''<BR>'''(i.e., left main or proximal 2-vessel coronary artery dissection)'''|B02='''Clinically stable <BR>with left main or severe proximal 2-vessel dissection'''|B03='''Active/ongoing ischemia <BR>or hemodynamic instability'''}}
-{{Familytree | | | |L|~|~|~|~|~|%|~|~|~|~|~|J| | | |}}
+{{Familytree | | | |!| | | | | |!| | | | | |!| | | |}}
-{{Familytree | | | | | | | | | C01 | | | | | | | | |C01='''If diagnostic uncertainty, consider adjunctive diagnostic strategies:'''<BR><div style="text-align: left; padding: 5px;">❑&nbsp;&nbsp;OCT/IVUS if feasible/safe<BR>❑&nbsp;&nbsp;CT coronary angiography<BR>❑&nbsp;&nbsp;CTA/MRA/angiographic imaging for extracoronary vasculopathy/FMD<BR>❑&nbsp;&nbsp;Repeat coronary angiography at 6–8 weeks</div>}}
+{{Familytree | | | C01 | | | | C02 | | | | C03 | | |C01=<div style="text-align: left; padding: 5px;">❑&nbsp;&nbsp;Conservative therapy<BR>❑&nbsp;&nbsp;Monitor as inpatient 3–5 days</div>|C02=<div style="text-align: left; padding: 5px;">❑&nbsp;&nbsp;Consider CABG<BR>❑&nbsp;&nbsp;Conservative Rx may be reasonable</div>|C03=<div style="text-align: left; padding: 5px;">❑&nbsp;&nbsp;Consider PCI if feasible, OR<BR>❑&nbsp;&nbsp;Urgent CABG (based on technical considerations and local expertise</div>}}
 {{Family tree/end}}