Spontaneous coronary artery dissection natural history, complications and prognosis

Jump to navigation Jump to search

Spontaneous Coronary Artery Dissection Microchapters



Historical Perspective




Differentiating Spontaneous coronary artery dissection from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


Diagnostic Approach

History and Symptoms

Physical Examination

Laboratory Findings






Other Imaging Findings

Other Diagnostic Studies


Treatment Approach

Medical Therapy

Percutaneous Coronary Intervention


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. Arzu Kalayci, M.D. [2]

Synonyms and keywords: SCAD


The natural history of spontaneous coronary artery dissection has not been well characterized. Early reports based on post-mortem examinations after sudden cardiac death suggest a dismal prognosis. However, recent studies demonstrate that the majority of patients survive initial hospitalization and have a favorable prognosis following clinical stabilization. Some of the complications of SCAD include extension of dissection, recurrence of dissection, myocardial stunning, myocardial infarction, congestive heart failure, cardiogenic shock, ventricular arrhythmia, and sudden cardiac death.

Natural History, Complications and Prognosis

Natural History


Complications include:



  1. Kolle, Patrick T.; Cliffe, Charles M.; Ridley, David J. (1998). "Immunosuppressive therapy for peripartum-type spontaneous coronary artery dissection: Case report and review". Clinical Cardiology. 21 (1): 40–46. doi:10.1002/clc.4960210108. ISSN 0160-9289.
  2. 2.0 2.1 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.
  3. Rogowski, Sebastian; Maeder, Micha T.; Weilenmann, Daniel; Haager, Philipp K.; Ammann, Peter; Rohner, Franziska; Joerg, Lucas; Rickli, Hans (2017). "Spontaneous Coronary Artery Dissection". Catheterization and Cardiovascular Interventions. 89 (1): 59–68. doi:10.1002/ccd.26383. ISSN 1522-1946.
  4. Tweet, M. S.; Hayes, S. N.; Pitta, S. R.; Simari, R. D.; Lerman, A.; Lennon, R. J.; Gersh, B. J.; Khambatta, S.; Best, P. J. M.; Rihal, C. S.; Gulati, R. (2012). "Clinical Features, Management, and Prognosis of Spontaneous Coronary Artery Dissection". Circulation. 126 (5): 579–588. doi:10.1161/CIRCULATIONAHA.112.105718. ISSN 0009-7322.
  5. Tweet, M. S.; Eleid, M. F.; Best, P. J. M.; Lennon, R. J.; Lerman, A.; Rihal, C. S.; Holmes, D. R.; Hayes, S. N.; Gulati, R. (2014). "Spontaneous Coronary Artery Dissection: Revascularization Versus Conservative Therapy". Circulation: Cardiovascular Interventions. 7 (6): 777–786. doi:10.1161/CIRCINTERVENTIONS.114.001659. ISSN 1941-7640.
  6. Nakashima, Takahiro; Noguchi, Teruo; Haruta, Seiichi; Yamamoto, Yusuke; Oshima, Shuichi; Nakao, Koichi; Taniguchi, Yasuyo; Yamaguchi, Junichi; Tsuchihashi, Kazufumi; Seki, Atsushi; Kawasaki, Tomohiro; Uchida, Tatsuro; Omura, Nobuhiro; Kikuchi, Migaku; Kimura, Kazuo; Ogawa, Hisao; Miyazaki, Shunichi; Yasuda, Satoshi (2016). "Prognostic impact of spontaneous coronary artery dissection in young female patients with acute myocardial infarction: A report from the Angina Pectoris–Myocardial Infarction Multicenter Investigators in Japan". International Journal of Cardiology. 207: 341–348. doi:10.1016/j.ijcard.2016.01.188. ISSN 0167-5273.
  7. 7.0 7.1 Saw, Jacqueline; Humphries, Karin; Aymong, Eve; Sedlak, Tara; Prakash, Roshan; Starovoytov, Andrew; Mancini, G.B. John (2017). "Spontaneous Coronary Artery Dissection". Journal of the American College of Cardiology. 70 (9): 1148–1158. doi:10.1016/j.jacc.2017.06.053. ISSN 0735-1097.
  8. Prakash, Roshan; Starovoytov, Andrew; Heydari, Milad; Mancini, G.B. John; Saw, Jacqueline (2016). "Catheter-Induced Iatrogenic Coronary Artery Dissection in Patients With Spontaneous Coronary Artery Dissection". JACC: Cardiovascular Interventions. 9 (17): 1851–1853. doi:10.1016/j.jcin.2016.06.026. ISSN 1936-8798.
  9. Hany Awadalla, Sameh Sabet, Ashraf El Sebaie, Oscar Rosales & Richard Smalling (2005). "Catheter-induced left main dissection incidence, predisposition and therapeutic strategies experience from two sides of the hemisphere". The Journal of invasive cardiology. 17 (4): 233–236. PMID 15831980. Unknown parameter |month= ignored (help)
  10. 10.0 10.1 Saw J, Aymong E, Sedlak T, Buller CE, Starovoytov A, Ricci D; et al. (2014). "Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes". Circ Cardiovasc Interv. 7 (5): 645–55. doi:10.1161/CIRCINTERVENTIONS.114.001760. PMID 25294399.
  11. Tweet MS, Eleid MF, Best PJ, Lennon RJ, Lerman A, Rihal CS; et al. (2014). "Spontaneous coronary artery dissection: revascularization versus conservative therapy". Circ Cardiovasc Interv. 7 (6): 777–86. doi:10.1161/CIRCINTERVENTIONS.114.001659. PMID 25406203.
  12. Tweet MS, Hayes SN, Pitta SR, Simari RD, Lerman A, Lennon RJ; et al. (2012). "Clinical features, management, and prognosis of spontaneous coronary artery dissection". Circulation. 126 (5): 579–88. doi:10.1161/CIRCULATIONAHA.112.105718. PMID 22800851.