المؤلفون: Hong, Jimmy¹ jimmyhong94@gmail.com, Tomcho, Jeremy C.¹, Mai, Steven L.², Khalife, Wissam¹

المصدر: American Journal of Case Reports. 6/11/2024, Vol. 25, p1-4. 4p.

مصطلحات موضوعية: *SPONTANEOUS coronary artery dissection, *IMPLANTABLE cardioverter-defibrillators, *CHEST pain, *VENTRICULAR arrhythmia, *RETURN of spontaneous circulation, *ANTERIOR wall myocardial infarction, *CARDIAC arrest

مستخلص: Objective: Unusual or unexpected effect of treatment Background: Spontaneous coronary artery dissection can present with acute coronary syndrome, ventricular arrhythmias, or sudden cardiac death. Implantable cardioverter-defibrillator placement in patients with spontaneous coronary artery dissection is controversial. The purpose of publishing this case is to inform physicians of potential benefits of implantable cardioverter-defibrillator implantation in patients with spontaneous coronary artery dissection. Case Report: A 55-year-old woman presented with chest pain, with an electrocardiogram revealing anterior ST-elevation myocardial infarction and troponin peak of 53.8 ng/mL. Coronary angiography revealed mid-left anterior descending artery occlusion, with appearance of spontaneous coronary artery dissection that was not amenable to revascularization. The decision was made to treat medically. In recovery, the patient experienced ventricular fibrillation arrest. The patient was defibrillated once with achievement of return of spontaneous circulation. An Impella CP was placed to stabilize the patient. After the patient was stabilized, an implantable cardiovert-er-defibrillator was placed. Conclusions: Data on potential benefits of implantable cardioverter-defibrillator placement in patients with spontaneous coronary artery dissection are limited. Most patients with spontaneous coronary artery dissection recover normal coronary architecture; however, there are no guidelines for implantable cardioverter-defibrillator placement in patients with spontaneous coronary artery dissection. Patients with spontaneous coronary artery dissection with high-risk features may benefit from implantable cardioverter-defibrillator for secondary prevention of ventricular arrhythmia and sudden cardiac death, as shown with this case. [ABSTRACT FROM AUTHOR]

المؤلفون: Wells, Bryan J¹ (AUTHOR) bjwells@emory.edu, Wood, Malissa J^2,3 (AUTHOR), O'Duffy, Anne E⁴ (AUTHOR), Sumner, Jennifer A⁵ (AUTHOR), Chi, Gerald⁶ (AUTHOR), Grodzinsky, Anna⁷ (AUTHOR), Gornik, Heather L⁸ (AUTHOR), Kadian-Dodov, Daniella⁹ (AUTHOR), Taylor, Angela¹⁰ (AUTHOR), Hess, Connie N¹¹ (AUTHOR), Sanghavi, Monika¹² (AUTHOR), Henkin, Stanislav^13,14 (AUTHOR), Wells, Gretchen^15,16 (AUTHOR), Tam, Lori¹⁷ (AUTHOR), Orford, James¹⁸ (AUTHOR), Lindley, Kathryn^19,20 (AUTHOR), Kumbhani, Dharam J²¹ (AUTHOR), Vitarello, Clara⁶ (AUTHOR), Alkhalfan, Fahad⁶ (AUTHOR), Gibson, C Michael⁶ (AUTHOR)

المصدر: Vascular Medicine. Jun2024, Vol. 29 Issue 3, p286-295. 10p.

مصطلحات موضوعية: *SPONTANEOUS coronary artery dissection, *MIGRAINE, *CAROTID artery dissections, *DISABILITIES, *FIBRODYSPLASIA ossificans progressiva, *MYOCARDIAL infarction

مستخلص: Introduction: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic cause of myocardial infarction. Migraine headache has been reported to be common among patients with SCAD, but the degree of migraine-related disability has not been quantified. Methods: Clinical data and headache variables were obtained from the baseline assessment of the prospective, multicenter iSCAD Registry. Migraine-related disability was quantified using the self-reported Migraine Disability Assessment (MIDAS). Demographic, clinical, psychosocial, and medical characteristics from data entry forms were compared between patients with and without migraine. Results: Of the 773 patients with available data, 46% reported previous or current migraines. Those with migraines were more likely to be women (96.9% vs 90.3%, p = 0.0003). The presence of underlying carotid fibromuscular dysplasia was associated with migraine (35% vs 27%, p = 0.0175). There was not a significant association with carotid artery dissection and migraine. Current migraine frequency was less than monthly (58%), monthly (24%), weekly (16%), and daily (3%). Triptan use was reported in 32.5% of patients, and 17.5% used daily migraine prophylactic medications. Using the MIDAS to quantify disability related to migraine, 60.2% reported little or no disability, 14.4% mild, 12.7% moderate, and 12.7% severe. The mean MIDAS score was 9.9 (mild to moderate disability). Patients with SCAD had higher rates of depression and anxiety (28.2% vs 17.7% [ p = 0.0004] and 35.3% vs 26.7% [ p = 0.0099], respectively). Conclusions: Migraines are common, frequent, and a source of disability in patients with SCAD. The association between female sex, anxiety, and depression may provide some insight for potential treatment modalities. [ABSTRACT FROM AUTHOR]

المؤلفون: Tsigkas, Grigorios¹ (AUTHOR) gregtsig@hotmail.com, Bozika, Maria¹ (AUTHOR) kassienmarie@gmail.com, Nastouli, Kassiani-Maria¹ (AUTHOR) michaeiaroutouia@gmail.com, Apostolos, Anastasios² (AUTHOR) anastasisapostolos@gmail.com, Routoula, Michaela¹ (AUTHOR) marisiag15@gmail.com, Georga, Athanasia-Maria¹ (AUTHOR) anastacialatta@gmail.com, Latta, Anastasia¹ (AUTHOR) aggelikip.1502@gmail.com, Papageorgiou, Angeliki¹ (AUTHOR) m.papafaklis@yahoo.com, Papafaklis, Michail I.¹ (AUTHOR) levent2669@gmail.com, Leventopoulos, Georgios¹ (AUTHOR) pdav@upatras.gr, Karamasis, Grigoris V.³ (AUTHOR) grigoris.karamasis@gmail.com, Davlouros, Periklis¹ (AUTHOR)

المصدر: Life (2075-1729). Mar2024, Vol. 14 Issue 3, p315. 14p.

مصطلحات موضوعية: *SPONTANEOUS coronary artery dissection, *LITERATURE reviews, *COVID-19 pandemic, *COVID-19, *MYOCARDIAL infarction

مستخلص: SARS-CoV-2 is responsible for the global coronavirus disease 2019 (COVID-19) pandemic. While the cardiovascular effects of COVID-19 have been thoroughly described, there are limited published studies in the literature establishing a connection between spontaneous coronary artery dissection (SCAD) and COVID-19. Cardiovascular manifestations include, among others, myocarditis, acute myocardial infraction, and thrombosis. In general, SCAD is an uncommon and underdiagnosed cause of acute myocardial infarction (AMI), particularly in younger women and in patients with underlying fibromuscular dysplasia (FMD). Many patients with SCAD often report significant emotional stress, especially in relation with job loss, during the week preceding their cardiac event. Moreover, the COVID-19 pandemic has led to societal stress and increased unemployment, factors that have been associated with cardiovascular morbidity. SCAD emerges as a rare manifestation of coronary artery disease, which a few recent case reports link to COVID-19. The aim of this article is to summarize the relevant data on the pathophysiology of COVID-19 and SCAD along with a review of the reported cases on acute coronary syndrome (ACS) following SARS-CoV2 infection and, thus, to provide insights about the relationship between COVID-19 and SCAD. [ABSTRACT FROM AUTHOR]

المؤلفون: Lee, Oliver¹ (AUTHOR), Sun, Kelly¹ (AUTHOR), Goldstein, Elianna² (AUTHOR), Jang, James³ (AUTHOR), Berenberg, Jeffrey⁴ (AUTHOR)

المصدر: Military Medicine. Mar/Apr2024, Vol. 189 Issue 3/4, pe888-e893. 6p.

مصطلحات موضوعية: *CHEST pain, *SPONTANEOUS coronary artery dissection, *HEARTBURN, *DELAYED diagnosis, *VENOUS thrombosis, *CARDIAC arrest, *CARDIOVASCULAR diseases risk factors

مصطلحات جغرافية: OKINAWA-ken (Japan)

مستخلص: Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic cause of myocardial infarction and sudden cardiac death in young individuals without significant cardiovascular risk factors. The etiology of SCAD appears to be multifactorial and is often precipitated by physical and emotional stress superimposed on underlying arteriopathy, connective tissue disorders, systemic inflammatory disorders, genetic factors, and hormonal influences. There are no current societal guidelines to stratify young soldiers' risk of developing SCAD. Diagnosis typically requires invasive coronary artery angiography which is largely unavailable in stations with limited medical resources. Furthermore, young patients with SCAD often present with atypical cardiac symptoms, such as heartburn leading to the misdiagnosis of gastroesophageal reflux disease and a delay in diagnosis and management. We present a 21-year-old active duty male who was transferred from Okinawa, Japan to a tertiary military medical center for evaluation of hypercoagulable conditions after CT revealed non-obstructing portal venous thrombosis extending to right hepatic vein, splenic vein thrombosis with splenic infarct, and bilateral wedge-shaped renal infarct. Extensive work-up ultimately revealed mid-left anterior descending spiral dissection with transmural infarct of inferior, anteroseptal, and inferoseptal wall resulting in the formation of left ventricular thrombus, subsequently causing thromboembolism to multiple organs. This case demonstrates the ramifications of SCAD when diagnosis and management are delayed and serve as a poignant reminder for all providers to include SCAD in the differential diagnosis for young soldiers with atypical chest pain. [ABSTRACT FROM AUTHOR]

المؤلفون: Dick, Michael¹ (AUTHOR), Kay, I. Patrick¹ (AUTHOR), Looi, Jen-Li¹ (AUTHOR) JenLi.Looi@middlemore.co.nz

المصدر: Cardiovascular Revascularization Medicine. Jul2024, Vol. 64, p87-89. 3p.

مصطلحات موضوعية: *SPONTANEOUS coronary artery dissection, *TAKOTSUBO cardiomyopathy

المؤلفون: Murphy, Barbara M. (AUTHOR), Rogerson, Michelle C. (AUTHOR), Le Grande, Michael R. (AUTHOR), Hesselson, Stephanie (AUTHOR), Iismaa, Siiri E. (AUTHOR), Graham, Robert M. (AUTHOR), Jackson, Alun C. (AUTHOR)

المصدر: PLoS ONE. 5/30/2024, Vol. 19 Issue 5, p1-3. 3p.

مصطلحات موضوعية: *SPONTANEOUS coronary artery dissection, *CORONARY arteries, *QUANTITATIVE research

مستخلص: Fig 1 is incorrect. Domains 1–6 are missing in the published figure. Please see the correct Fig 1 here.Graph: Fig 1 Ratings for all SCAD psychosocial impact items across the eight domains.N = 293. Note: SCAD = Spontaneous coronary artery dissection.By Barbara M. Murphy; Michelle C. Rogerson; Michael R. Le Grande; Stephanie Hesselson; Siiri E. Iismaa; Robert M. Graham and Alun C. JacksonReported by Author; Author; Author; Author; Author; Author; Author [Extracted from the article]

المؤلفون: Murphy, Barbara M.^1,2 (AUTHOR) barbara.murphy@australianhearthealth.org.au, Rogerson, Michelle C.¹ (AUTHOR), Le Grande, Michael R.^1,2 (AUTHOR), Hesselson, Stephanie³ (AUTHOR), Iismaa, Siiri E.^3,4 (AUTHOR), Graham, Robert M.^3,4 (AUTHOR), Jackson, Alun C.^1,2,5 (AUTHOR)

المصدر: PLoS ONE. 1/5/2024, Vol. 19 Issue 1, p1-22. 22p.

مصطلحات موضوعية: *SPONTANEOUS coronary artery dissection, *QUANTITATIVE research, *MYOCARDIAL infarction, *DRUG-eluting stents

مستخلص: Introduction: Recent studies suggest that acute myocardial infarction due to spontaneous coronary artery dissection (SCAD) carries significant psychosocial burden. This survey-based quantitative study builds on our earlier qualitative investigation of the psychosocial impacts of SCAD in Australian SCAD survivors. The study aimed to document the prevalence and predictors of a broad range of psychosocial and lifestyle impacts of SCAD. Method: Australian SCAD survivors currently enrolled in the Victor Chang Cardiac Research Institute genetics study were invited to participate in an online survey to assess the psychosocial impacts of SCAD. Participants completed a questionnaire, developed using findings from our earlier qualitative research, which assessed 48 psychosocial and five lifestyle impacts of SCAD. Participants also provided demographic and medical data and completed validated measures of anxiety and depression. Results: Of 433 SCAD survivors invited to participate, 310 (72%) completed the questionnaire. The most common psychosocial impacts were 'shock about having a heart attack' (experienced by 87% respondents), 'worry about having another SCAD' (81%), 'concern about triggering another SCAD' (77%), 'uncertainty about exercise and physical activity' (73%) and 'confusion about safe levels of activity and exertion' (73.0%) and 'being overly aware of bodily sensations' (73%). In terms of lifestyle impacts, the SCAD had impacted on work capacity for almost two thirds of participants, while one in ten had sought financial assistance. The key predictors of psychosocial impacts were being under 50, current financial strain, and trade-level education. The key predictors of lifestyle impacts were being over 50, SCAD recurrence, trade-level education, and current financial strain. All psychosocial impacts and some lifestyle impacts were associated with increased risk of anxiety and/or depression. Conclusion and implications: This quantitative study extends our previous qualitative investigation by documenting the prevalence of each of 48 psychosocial and five lifestyle impacts identified in our earlier focus group research, and by providing risk factors for greater SCAD impacts. The findings suggest the need for supports to address initial experiences of shock, as well as fears and uncertainties regarding the future, including SCAD recurrence and exercise resumption. Support could be targeted to those with identified risk factors. Strategies to enable SCAD survivors to remain in or return to the paid workforce are also indicated. [ABSTRACT FROM AUTHOR]

المؤلفون: Wang, Yongwei^1,2 (AUTHOR), Wan, Yuyang^1,2 (AUTHOR), Chen, Zhongjiang³ (AUTHOR) zjchen@fjmu.edu.cn

المصدر: Journal of Innovative Optical Health Sciences. Jan2024, Vol. 17 Issue 1, p1-10. 10p.

مصطلحات موضوعية: *SPONTANEOUS coronary artery dissection, *OPTICAL coherence tomography, *IMAGING systems, *THROMBOSIS, *CORONARY arteries, *INTRAVASCULAR ultrasonography, *ACOUSTIC imaging, *PHOTOACOUSTIC spectroscopy

مستخلص: In this work, we present an intravascular dual-mode endoscopic system capable of both intravascular photoacoustic imaging (IVPAI) and intravascular optical coherence tomography (IVOCT) for recognizing spontaneous coronary artery dissection (SCAD) phantoms. IVPAI provides high-resolution and high-penetration images of intramural hematoma (IMH) at different depths, so it is especially useful for imaging deep blood clots associated with imaging phantoms. IVOCT can readily visualize the double-lumen morphology of blood vessel walls to identify intimal tears. We also demonstrate the capability of this dual-mode endoscopic system using mimicking phantoms and biological samples of blood clots in ex vivo porcine arteries. The results of the experiments indicate that the combined IVPAI and IVOCT technique has the potential to provide a more accurate SCAD assessment method for clinical applications. [ABSTRACT FROM AUTHOR]

المؤلفون: Al-Mahrizi, Balqees¹ ahmedalkindi87@gmail.com, Al Kindi, Fahad¹, Al Kindi, Faiza, Al Hajri, Ruqyia, Al Ismaili, Abdullah¹, Al Kindi, Ahmed

المصدر: Heart Views. Jan-Mar2024, Vol. 25 Issue 1, p37-41. 5p.

مصطلحات موضوعية: *SPONTANEOUS coronary artery dissection, *CHEST pain, *ACUTE coronary syndrome, *YOUNG women, *DYSPLASIA, *CORONARY angiography

مستخلص: Spontaneous coronary artery dissection (SCAD) is a well-recognized cause of acute coronary syndrome (ACS) which can lead to myocardial infarction and sudden death. Unlike typical atherosclerosis, SCAD operates through distinct pathophysiology, affecting both individuals with and without conventional cardiovascular risk factors. We present a case of a young female presented with retrosternal chest pain radiating to the left arm, mimicking ACS symptoms with mildly elevated troponin levels, and slightly reduced left ventricular ejection fraction (45%). Subsequent evaluation using coronary angiography unveiled a Type 2A SCAD. A comprehensive computed tomography angiography (CTA) of her entire body revealed findings suggestive of fibromuscular dysplasia (FMD) affecting multiple arteries in different sites. Our case entailed the successful management of a young female patient with SCAD stemming from FMD. [ABSTRACT FROM AUTHOR]

المؤلفون: Turner, Elizabeth A.¹ (AUTHOR) elizabeth.a.turner-1@student.uts.edu.au, Ivynian, Serra E.¹ (AUTHOR), Hickman, Louise^1,2 (AUTHOR), DiGiacomo, Michelle¹ (AUTHOR)

المصدر: Heart, Lung & Circulation. Dec2023, Vol. 32 Issue 12, p1426-1433. 8p.

مصطلحات موضوعية: *SPONTANEOUS coronary artery dissection, *PATIENT experience, *PATIENTS' attitudes, *LITERATURE reviews, *POST-traumatic stress disorder, *PSYCHOLOGICAL distress

مستخلص: There is considerable burden of anxiety, depression, and post-traumatic stress disorder in patients with spontaneous coronary artery dissection (SCAD), yet research is limited on the experience and impact of SCAD from the patient perspective. This literature review sought to describe the current state of the literature on the patient experience of SCAD and consequences for patients following a SCAD event from the patient perspective. To better understand how people's experiences of SCAD affect their wellbeing, quality of life, lifestyles, and identity, and what would be useful from the patient perspective, an integrative review was performed. An integrative literature review was conducted to understand the experience of SCAD and the post-event implications. Five databases were searched. Search terms included 'spontaneous coronary artery dissection', 'SCAD', 'patient', 'experience', 'perspective', and 'opinion'. English-language, peer-reviewed primary research in people with a diagnosis of SCAD that reflected the patient experience was included. Data indicating the SCAD experience including distress prevalence were extracted into an Excel spreadsheet, and narrative synthesis of included studies followed. From 325 identified studies, five were included for review, yielding a combined sample of 447 participants. Patients with SCAD reported a lack of information about SCAD and the recovery process, and use of the internet for obtaining information. Patients with SCAD reported challenges in recovery including anxiety associated with fear of recurrence and uncertainty, and a need for greater support. A wide range of negative emotions was reported during and after the SCAD event. Participants reported participating in support groups, with mixed reviews of their appropriateness and effectiveness. [ABSTRACT FROM AUTHOR]