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Regional and temporal variations of spontaneous coronary artery dissection care according to consensus recommendations: a systematic review and meta-analysis

Open Heart

Aim The first expert consensus documents on management of patients with spontaneous coronary artery dissection (SCAD) were published in 2018. We aim to review the proportion of patients with SCAD receiving consensus recommendations globally, regionally and, determine differences in practice before and after 2018.

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Healthy 45-year-old with chest pain: early repolarization, pericarditis or injury?

Dr. Smith's ECG Blog

Here is the post shock ECG: Cardiology was called stat for ischemic VT, query SCAD vs thrombotic occlusion vs coronary vasospasm. Cath lab was activated: There was no coronary artery disease, but there was spontaneous coronary artery dissection (SCAD) of the distal LAD, which was narrowed by 95%, and treated medically.

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A young peripartum woman with Chest Pain

Dr. Smith's ECG Blog

In the absence of these factors it is termed spontaneous coronary artery dissection ( SCAD ). At that time the literature suggested: SCAD was rare , Mostly related to pregnancy , Seen on angiography as a dissection flap , and Managed similarly to MI caused by CAD (ASA, BB, lytics/PCI ). This case occurred 10+ years ago.

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An athletic 30-something woman with acute substernal chest pressure

Dr. Smith's ECG Blog

What is Spontaneous Coronary Artery Dissection (SCAD)? I asked Angie Lobo ( [link] ), a third year intermal medicine resident at Abbott Northwestern Hospital (and Minneapolis Heart Institute) and an aspiring cardiologist, to write a couple paragraphs on SCAD. There are no randomized controlled trials for treatment strategies in SCAD.

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1 hour of CPR, then ECMO circulation, then successful defibrillation.

Dr. Smith's ECG Blog

Spontaneous coronary artery dissection (SCAD) should be considered as a cause of MINOCA. Shark Fin morphology has been discussed a number of times on Dr. Smith’s ECG Blog ( For review — See the June 11, 2018 post and the January 24, 2020 post , to name just 2 instances ).