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Spontaneous coronary artery dissection (SCAD) is an uncommon condition which is increasingly recognized as a cause of significant morbidity. SCAD can cause acute coronary syndrome and myocardial infarction (MI), as well as sudden cardiac death. The standard of care for patients with SCAD is rapidly evolving.
Jesse McLaren on when to consider Spontaneous Coronary Artery Dissection (SCAD), which patients are at risk for reocclusion, and the challenges of diagnosing SCAD in patients who have nonischemic ECGs despite silent occlusion, occlusions perfused by collaterals, or from non-occlusive MI on this ECG Cases.
Patients with spontaneous coronary artery dissection (SCAD) who are discharged on oral anticoagulation (OAC) or dual antiplatelet therapy (DAPT) that combines aspirin plus ticagrelor have a higher risk of major adverse cardiovascular events (MACE),
(MedPage Today) -- Consensus recommendations for spontaneous coronary artery dissection (SCAD) have been applied inconsistently despite increasing awareness of this condition, according to a meta-analysis. Observational studies showed significant.
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. female) were included.
Background Contemporary management of spontaneous coronary artery dissection (SCAD) is still controversial. Results The systematic review included 13 observational studies evaluating 1,801 patients with SCAD. Results The systematic review included 13 observational studies evaluating 1,801 patients with SCAD. Approximately 48.5%
BackgroundClinical practice guidelines for the management and convalescence of patients with spontaneous coronary artery dissection (SCAD) have yet to be developed. The awareness and detection of SCAD as a cardiac event was low among patients (35%) and perceived to be moderate among health care providers (55%). women; mean age, 53.2 years)
Introduction Spontaneous coronary artery dissection (SCAD) is a non-traumatic and non-iatrogenic separation of the coronary arterial wall. Results 14 studies with 2,145 females in the generative period with ACS caused by SCAD were analyzed. P-SCAD compared to NP-SCAD patients more frequently had STEMI (OR = 3.16; 95% CI: 2.30–4.34;
The final diagnosis was spontaneous coronary artery dissection (SCAD) starting in the mid LAD and continuing distally where it wraps around the apex. SCAD wasn't on my differential per se , but in retrospect it should have been. Most patients presenting with SCAD report a preceding emotional or physical stressor. Buller, C.
BackgroundSpontaneous coronary artery dissection (SCAD) significantly contributes to myocardial infarction among young individuals. After excluding single nucleotide polymorphisms (SNPs) confounded by extrinsic variables, the association of neuroticism scores with SCAD susceptibility persisted.
Spontaneous coronary artery dissection (SCAD), an uncommon cause of acute coronary syndrome, continues to be a poorly understood disease predominantly affecting females. It is a concomitant disease found among SCAD patients. It is characterized by an abrupt separation in the coronary arterial wall due to intramural bleeding.
Introduction Differences in pathophysiology, clinical presentation, and natural course of ST-elevation myocardial infarction in female patients due to either spontaneous dissection (SCAD-STEMI) or atherothrombotic occlusion (type 1 STEMI) have been discussed. vs. 1.8 ± 5.1%, p = 0.002). vs. 1.8 ± 5.1%, p = 0.002).
Background Spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS) constitute two common causes of nonatherosclerotic acute cardiac syndrome particularly frequent in women. Results A total of 289 SCAD and 150 TTS patients were included; 89% were women. In-hospital events (43.3% vs. 7.1%, HR 5.3, vs. 9.6%, HR 4.5,
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.
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 ). The SCAD cases in Lobo et al. Lobo et al.
Spontaneous coronary dissection vs Iatrogenic dissection SCAD is a rare , different entity , enjoys a popular space in the patho-physiology of CAD. An important therapeutic caution is PCI is contraindicated in SCAD except in critical locations such as left main. Is plaque fissure painful ?
Methods 701 patients were divided into stable coronary artery disease (SCAD), ACS, and control groups. Results The lg (circSCMH1/miR-874) values of ACS, SCAD, and the control group decreased successively ( P < 0.05). Then lg(circSCMH1/miR-874) was calculated and statistical analysis was performed.
Short-chain acyl-CoA dehydrogenase (SCAD) negatively regulates pathological cardiac hypertrophy. The purpose of this study was to investigate the possible role of SCAD in cardiac fibrosis. Short-chain acyl-CoA dehydrogenase (SCAD) negatively regulates pathological cardiac hypertrophy.
Currently, SCAD is a diagnosis that can only be established emergently in the cath lab with angiography. Type 1 ACS OMI should be ruled out as it is the most common and most treatable cause, and only with angiography will type 1 ACS be ruled out and SCAD be diagnosed instead. And is there new left bundle branch block (LBBB)?
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.
"People often believe that their 'silent' heart attack is something else - like the flu or a pulled muscle. Much later, when they end up getting diagnosed with a heart attack that they didn't know they were having, they might recall an episode of feeling vaguely unwell." - Dr. Leslie Cho
MINOCA now encompasses Spontaneous Coronary Artery Dissection (SCAD), a rare condition that is known to manifest primarily in women and affects the epicardial coronary artery. Despite padding the MINOCA numbers with SCAD, MINOCA is much rarer than conventional epicardial coronary disease. Which is exactly what the numbers show.
On this month's EM Quick Hits podcast: Ian Chernoff on the often elusive diagnosis of traumatic coronary artery dissection, Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia, Brit Long and Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management, Dave Jerome on recognition and management exercise-associated (..)
Spontaneous coronary artery dissection (SCAD) should be considered as a cause of MINOCA. Coronary microvascular dysfunction may contribute to MINOCA and requires further investigation. Coronary thrombosis or embolism can result in MINOCA, either with or without a hypercoagulable state.
Introduction Spontaneous coronary artery dissection (SCAD) accounts for 1%–4% of cases of acute coronary syndrome (ACS). SCAD is caused by separation occurring within or between any of the three tunics of the coronary artery wall. The incidence of SCAD is higher in women than in men, with a ratio of approximately 9:1.
Two-thirds of clinical research on heart disease is still done on white middle-aged men. Will this new grant fund a solution to an alarming gender gap?
In this week’s View, Dr. Eagle discusses the use of non–Vitamin-K antagonist oral anticoagulants versus warfarin across the spectrum of body mass index and weight.
Additional entities including spontaneous coronary artery dissection (SCAD), coronary microvascular disease (CMD), systemic autoimmune disorders, and mental and behavioral health will also be discussed in terms of their prevalence among women and their association with CVD.
Spontaneous coronary artery dissection (SCAD) is a relevant non-atherosclerotic cause of acute coronary syndrome with a complex genetic architecture. Recent discoveries have highlighted the potential role of miRNAs and protein-coding genes involved in the processing of small RNAs in the pathogenesis of SCAD.
It was not SCAD (coronary dissection) Highest troponin I was 37,000 ng/L, but it was not measured to peak. Angiogram Door to balloon time was 120 minutes (much too long) because of time taken for a CT. Coronary angiogram showed 100% mid LAD occlusion for which she received a DES with excellent angiographic result.
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