Spontaneous coronary artery dissection causes: Difference between revisions

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==Causes==
==Causes==


The exact etiology of spontaneous coronary artery dissection (SCAD) remains elusive and appears to be multifactorial.  The phenotypic manifestation of SCAD has been postulated to occur as a result of a predisposing factor compounded by a precipitating stressor.
The exact etiology of spontaneous coronary artery dissection (SCAD) remains elusive and appears to be multifactorial.  It has been postulated that the phenotypic manifestation of SCAD may occur as a result of predisposing factors compounded by precipitating stressors.<ref name="SawMancini2016">{{cite journal|last1=Saw|first1=Jacqueline|last2=Mancini|first2=G.B. John|last3=Humphries|first3=Karin H.|title=Contemporary Review on Spontaneous Coronary Artery Dissection|journal=Journal of the American College of Cardiology|volume=68|issue=3|year=2016|pages=297–312|issn=07351097|doi=10.1016/j.jacc.2016.05.034}}</ref>


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Revision as of 19:25, 28 November 2017

Spontaneous Coronary Artery Dissection Microchapters

Home

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

Type 2A

Type 2B

Type 3

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

Synonyms and keywords: SCAD

Overview

Causes

The exact etiology of spontaneous coronary artery dissection (SCAD) remains elusive and appears to be multifactorial. It has been postulated that the phenotypic manifestation of SCAD may occur as a result of predisposing factors compounded by precipitating stressors.[1]

Potential Cause Condition
Predisposing factors
  • Fibromuscular dysplasia
  • Takotsubo cardiomyopathy
  • Pregnancy-related: antepartum, early post-partum, late post-partum, very late post-partum
  • Recurrent pregnancies: multiparity or multigravida
  • Connective tissue disorder: Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome type 4, cystic medial necrosis, alpha-1 antitrypsin deficiency, polycystic kidney disease
  • Systemic inflammatory disease: systemic lupus erythematosus, Crohn's disease, ulcerative colitis, polyarteritis nodosa, sarcoidosis, Churg-Strauss syndrome, Wegener's granulomatosis, rheumatoid arthritis, Kawasaki disease, giant cell arteritis, celiac disease
  • Hormonal therapy: oral contraceptive, estrogen, progesterone, beta-HCG, testosterone, corticosteroids
  • Coronary artery spasm
  • Idiopathic
Precipitating stressors
  • Intense exercises including isometric or aerobic activities
  • Intense emotional stress
  • Labor and delivery
  • Intense Valsava-type activities: retching, vomiting, bowel movement, coughing
  • Recreational drugs: cocaine, amphetamines, metamphetamines
  • Intense hormonal therapy: beta-HCG injections, corticosteroids injections

References

  1. ↑ Saw, Jacqueline; Mancini, G.B. John; Humphries, Karin H. (2016). "Contemporary Review on Spontaneous Coronary Artery Dissection". Journal of the American College of Cardiology. 68 (3): 297–312. doi:10.1016/j.jacc.2016.05.034. ISSN 0735-1097.
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