Spontaneous coronary artery dissection causes
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Spontaneous Coronary Artery Dissection Microchapters |
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Differentiating Spontaneous coronary artery dissection from other Diseases |
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Diagnosis |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A. Arzu Kalayci, M.D. [2]
Synonyms and keywords: SCAD
Overview
The exact etiology of spontaneous coronary artery dissection remains elusive; however, fibromuscular dysplasia and takotsubo cardiomyopathy have been considered as the potential cause of spontaneous coronary artery dissection.
Causes
The exact etiology of spontaneous coronary artery dissection (SCAD) remains elusive and appears to be multifactorial. It has been postulated that the phenotypic expression of SCAD may occur as a result of predisposing factors compounded by precipitating stressors.[1] Among the conditions associated with the occurrence of SCAD, fibromuscular dysplasia (FMD) and takotsubo cardiomyopathy (TCM) have been postulated to have a causal relationship with SCAD.
Fibromuscular Dysplasia
FMD is a non-atherosclerotic vasculopathy characterized by thickening, fibrosis, and disarray of the arterial wall that primarily affects small and medium-sized vessels. The association between FMD and SCAD has been well described,[2][3][4][5] and the biological proof of causation has been supported by histopathologic reports.[6][7][8] It has been suggested that the presence of FMD may weaken the artery architecture and lead to aneurysm formation or coronary dissection.[9]
Takotsubo Cardiomyopathy
Both TCM and SCAD affect predominantly women and may be precipitated by emotional stress or strenuous exercise associated with sympathetic discharge. Numerous reports have described the concurrence of TCM and SCAD.[10][11][12][13][14] In the setting of TCM, vigorous contraction of the left ventricular base in conjunction with the adjacent akinetic/dyskinetic segments could form a prerequisite anatomic/functional substrate for the causation of SCAD.[15] The coronary dissection plane may develop as a result of excessive movement of the epicardial vessels and increased shear stress on the vessel wall at the hinge point between the hyperdynamic and dyskinetic/akinetic myocardium.[16] It has also been speculated that the coronary arteries traversing the anterior or anterolateral wall would be more vulnerable to dissection as this region marks the transition point of the hyperdynamic basal segment and the remaining dyskinetic/akinetic left ventricular segments. Another plausible mechanism is that elevated catecholamine concentrations in TCM may cause epicardial coronary vasoconstriction and/or spasm, which in turn leads to increased arterial shear stress and subsequent intimal tear or disruption of vasa vasorum.[17] On the contrary, it is noteworthy that the post-ischemic myocardial stunning associated with SCAD could lead to TCM,[11] thus forming the “TCM begets SCAD, and SCAD begets TCM” vicious cycle.
Causes
Life-threatening Causes
- Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. There are no life-threatening causes of disease name, however complications resulting from untreated disease name is common.
- Life-threatening causes of [symptom/manifestation] include [cause1], [cause2], and [cause3].
- [Cause] is a life-threatening cause of [disease].
Common Causes
Common causes of [disease name] may include:
- [Cause1]
- [Cause2]
- [Cause3]
OR
- [Disease name] is caused by an infection with [pathogen name].
- [Pathogen name] is caused by [pathogen name].
Less Common Causes
Less common causes of [disease name] include:
- [Cause1]
- [Cause2]
- [Cause3]
Genetic Causes
- [Disease name] is caused by a mutation in the [gene name] gene.
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | No underlying causes |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | No underlying causes |
| Musculoskeletal/Orthopedic | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional/Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal/Electrolyte | No underlying causes |
| Rheumatology/Immunology/Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |
Causes in Alphabetical Order
List the causes of the disease in alphabetical order:
- Cause 1
- Cause 2
- Cause 3
- Cause 4
- Cause 5
- Cause 6
- Cause 7
- Cause 8
- Cause 9
- Cause 10
References
- ↑ 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.
- ↑ Saw, J.; Poulter, R.; Fung, A.; Wood, D.; Hamburger, J.; Buller, C. E. (2012). "Spontaneous Coronary Artery Dissection in Patients With Fibromuscular Dysplasia: A Case Series". Circulation: Cardiovascular Interventions. 5 (1): 134–137. doi:10.1161/CIRCINTERVENTIONS.111.966630. ISSN 1941-7640.
- ↑ Saw, Jacqueline; Ricci, Donald; Starovoytov, Andrew; Fox, Rebecca; Buller, Christopher E. (2013). "Spontaneous Coronary Artery Dissection". JACC: Cardiovascular Interventions. 6 (1): 44–52. doi:10.1016/j.jcin.2012.08.017. ISSN 1936-8798.
- ↑ Toggweiler, S; Puck, M; Thalhammer, C; Manka, R; Wyss, M; Bilecen, D; Corti, R; Amann-Vesti, B; Lüscher, T; Wyss, C (2012). "Associated vascular lesions in patients with spontaneous coronary artery dissection". Swiss Medical Weekly. doi:10.4414/smw.2012.13538. ISSN 1424-7860.
- ↑ Saw, J.; Aymong, E.; Sedlak, T.; Buller, C. E.; Starovoytov, A.; Ricci, D.; Robinson, S.; Vuurmans, T.; Gao, M.; Humphries, K.; Mancini, G. B. J. (2014). "Spontaneous Coronary Artery Dissection: Association With Predisposing Arteriopathies and Precipitating Stressors and Cardiovascular Outcomes". Circulation: Cardiovascular Interventions. 7 (5): 645–655. doi:10.1161/CIRCINTERVENTIONS.114.001760. ISSN 1941-7640.
- ↑ Lie, J.T.; Berg, K.K. (1987). "Isolated fibromuscular dysplasia of the coronary arteries with spontaneous dissection and myocardial infarction". Human Pathology. 18 (6): 654–656. doi:10.1016/S0046-8177(87)80368-4. ISSN 0046-8177.
- ↑ Mather PJ, Hansen CL, Goldman B, Inniss S, Piña I, Norris R, Jeevanandam V, Bove AA (1994). "Postpartum multivessel coronary dissection". J. Heart Lung Transplant. 13 (3): 533–7. PMID 8061031.
- ↑ Brodsky, Sergey V.; Ramaswamy, Gita; Chander, Praveen; Braun, Alex (2007). "Ruptured Cerebral Aneurysm and Acute Coronary Artery Dissection in the Setting of Multivascular Fibromuscular Dysplasia". Angiology. 58 (6): 764–767. doi:10.1177/0003319707303645. ISSN 0003-3197.
- ↑ Olin, J. W.; Gornik, H. L.; Bacharach, J. M.; Biller, J.; Fine, L. J.; Gray, B. H.; Gray, W. A.; Gupta, R.; Hamburg, N. M.; Katzen, B. T.; Lookstein, R. A.; Lumsden, A. B.; Newburger, J. W.; Rundek, T.; Sperati, C. J.; Stanley, J. C. (2014). "Fibromuscular Dysplasia: State of the Science and Critical Unanswered Questions: A Scientific Statement From the American Heart Association". Circulation. 129 (9): 1048–1078. doi:10.1161/01.cir.0000442577.96802.8c. ISSN 0009-7322.
- ↑ Chou, Annie Y.; Sedlak, Tara; Aymong, Eve; Sheth, Tej; Starovoytov, Andrew; Humphries, Karin H.; Mancini, G.B. John; Saw, Jacqueline (2015). "Spontaneous Coronary Artery Dissection Misdiagnosed as Takotsubo Cardiomyopathy: A Case Series". Canadian Journal of Cardiology. 31 (8): 1073.e5–1073.e8. doi:10.1016/j.cjca.2015.03.018. ISSN 0828-282X.
- ↑ 11.0 11.1 Y-Hassan, Shams; Henareh, Loghman (2013). "Spontaneous coronary artery dissection triggered post-ischemic myocardial stunning and takotsubo syndrome: two different names for the same condition". Cardiovascular Revascularization Medicine. 14 (2): 109–112. doi:10.1016/j.carrev.2012.11.005. ISSN 1553-8389.
- ↑ Y-Hassan, Shams; Themudo, Raquel; Maret, Eva (2017). "Spontaneous coronary artery dissection and takotsubo syndrome: The chicken or the egg causality dilemma". Catheterization and Cardiovascular Interventions. 89 (7): 1215–1218. doi:10.1002/ccd.26956. ISSN 1522-1946.
- ↑ Y-Hassan, Shams; Böhm, Felix (2016). "The causal link between spontaneous coronary artery dissection and takotsubo syndrome: A case presented with both conditions". International Journal of Cardiology. 203: 828–831. doi:10.1016/j.ijcard.2015.11.047. ISSN 0167-5273.
- ↑ Yalta, Kenan; Ucar, Fatih; Yilmaztepe, Mustafa; Ozkalayci, Flora (2016). "Tako-tsubo cardiomyopathy and spontaneous coronary artery dissection: A subtle association with prognostic implications?". International Journal of Cardiology. 202: 174–176. doi:10.1016/j.ijcard.2015.08.152. ISSN 0167-5273.
- ↑ Madias, John E. (2015). "On a Plausible Association of Spontaneous Coronary Artery Dissection and Takotsubo Syndrome". Canadian Journal of Cardiology. 31 (11): 1410.e1. doi:10.1016/j.cjca.2015.07.720. ISSN 0828-282X.
- ↑ Madias, John E. (2017). "A Possible Amphidromic Relation Between Spontaneous Coronary Artery Dissection and Takotsubo Syndrome". The American Journal of Cardiology. 120 (3): e69. doi:10.1016/j.amjcard.2016.10.008. ISSN 0002-9149.
- ↑ Pelliccia, Francesco; Kaski, Juan Carlos; Crea, Filippo; Camici, Paolo G. (2017). "Pathophysiology of Takotsubo Syndrome". Circulation. 135 (24): 2426–2441. doi:10.1161/CIRCULATIONAHA.116.027121. ISSN 0009-7322.