2018 SCAD Ultrasound 
Dr. Smith's ECG Blog
OCTOBER 24, 2019
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.
Dr. Smith's ECG Blog
MAY 19, 2020
The ways to tell for certain include intravascular ultrasound (to look for extra-luminal plaque with rupture) or "optical coherence tomography," something I am entirely unfamiliar with. The authors recommend using optical coherence tomography or intravascular ultrasound imaging in patients with evidence of nonobstructive CAD by angiogram.
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