Coronary artery dissection - Revision history

Rossdonaldson1: /* Evaluation */

2021-07-01T22:53:28Z

Evaluation

← Older revision		Revision as of 22:53, 1 July 2021
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	==Evaluation==		==Evaluation==
			[[File:PMC3424780 HV-13-53-g003.png\|thumb\|ECG showing ST elevation in the antero-lateral leads in a patient with coronary artery dissection.]]
	===Workup===		===Workup===
	*[[EKG]]		*[[EKG]]

Rossdonaldson1 at 22:50, 1 July 2021

2021-07-01T22:50:46Z

← Older revision		Revision as of 22:50, 1 July 2021
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	*Spontaneous tear in the intimal wall of a coronary artery leading to a false lumen and intramural hematoma, similar to [[aortic dissection]]		*Spontaneous tear in the intimal wall of a coronary artery leading to a false lumen and intramural hematoma, similar to [[aortic dissection]]
	*Much more common in young women		*Much more common in young women
	*Usually presents as an Anterior MI with ST changes in anterior Precordial leads (V1-V3)

	===Causes===		===Causes===
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	==Evaluation==		==Evaluation==
			===Workup===
	*[[EKG]]		*[[EKG]]
	*~~Labs~~		**Usually presents as an Anterior MI with ST changes in anterior Precordial leads (V1-V3)
	**[[~~Troponin~~]] ~~may be elevated~~		*Basic labs, including [[troponin]]
	*[[Echocardiography]]		*[[Echocardiography]]
	*~~Cardiology consultation~~
	*~~Diagnosis~~ made at time of coronary angiography		===Diagnosis===
			*[[EKG]] usually shows an Anterior MI with ST changes in anterior Precordial leads (V1-V3)
			*[[Troponin]] may be elevated
			*Definitive diagnosis made at time of coronary angiography

	==Management==		==Management==
	*[[Aspirin]], [[beta-blockers\|β-blocker]], and 1 year of [[clopidogrel]]<ref>Saw J, Aymong E, Sedlak T, et al. Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes. Circ Cardiovasc Interv 2014; 7:645.</ref>		*[[Aspirin]], [[beta-blockers\|β-blocker]], and 1 year of [[clopidogrel]]<ref>Saw J, Aymong E, Sedlak T, et al. Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes. Circ Cardiovasc Interv 2014; 7:645.</ref>
	*PCI can be challenging given vessel wall fragility		*Cardiology consultation
			**PCI can be challenging given vessel wall fragility

	==Disposition==		==Disposition==

Blsimpso at 20:59, 1 July 2021

2021-07-01T20:59:32Z

← Older revision		Revision as of 20:59, 1 July 2021
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	*[[Chest Pain]]		*[[Chest Pain]]
	*[[ST-segment_elevation_myocardial_infarction_(STEMI)\|STEMI]]		*[[ST-segment_elevation_myocardial_infarction_(STEMI)\|STEMI]]

			==External Links==
			*[https://rebelem.com/spontaneous-coronary-artery-dissection-scad/ Rebel EM - Spontaneous Coronary Artery Dissection]

	==References==		==References==

Rossdonaldson1: /* Background */

2020-08-12T21:22:18Z

Background

← Older revision		Revision as of 21:22, 12 August 2020
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	==Background==		==Background==
			[[File:RevisedSCAD.png\|thumb\|Illustration showing coronary artery dissection with formation of a hematoma (purple) within the walls of the coronary artery.]]
	*Spontaneous tear in the intimal wall of a coronary artery leading to a false lumen and intramural hematoma, similar to [[aortic dissection]]		*Spontaneous tear in the intimal wall of a coronary artery leading to a false lumen and intramural hematoma, similar to [[aortic dissection]]
	*Much more common in young women		*Much more common in young women

Fredvarone: /* Background */

2020-08-04T16:08:35Z

Background

← Older revision		Revision as of 16:08, 4 August 2020
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	==Background==		==Background==
			*Spontaneous tear in the intimal wall of a coronary artery leading to a false lumen and intramural hematoma, similar to [[aortic dissection]]
			*Much more common in young women
	*Usually presents as an Anterior MI with ST changes in anterior Precordial leads (V1-V3)		*Usually presents as an Anterior MI with ST changes in anterior Precordial leads (V1-V3)

Fredvarone: /* Evaluation */

2020-08-04T16:01:26Z

Evaluation

← Older revision		Revision as of 16:01, 4 August 2020
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	==Evaluation==		==Evaluation==
			*[[EKG]]
			*Labs
			**[[Troponin]] may be elevated
			*[[Echocardiography]]
			*Cardiology consultation
	*Diagnosis made at time of coronary angiography		*Diagnosis made at time of coronary angiography

Mholtz at 02:56, 26 September 2019

2019-09-26T02:56:32Z

← Older revision		Revision as of 02:56, 26 September 2019
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	*Fibromuscular dysplasia		*Fibromuscular dysplasia
	*Underling [[connective tissue disorder]]		*Underling [[connective tissue disorder]]
			*Iatrogenic (during coronary angiography)

	==Clinical Features==		==Clinical Features==
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	==Disposition==		==Disposition==
			*Admit

	==See Also==		==See Also==

ClaireLewis at 18:37, 24 September 2019

2019-09-24T18:37:46Z

← Older revision		Revision as of 18:37, 24 September 2019
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	==Clinical Features==		==Clinical Features==
	*Chest or shoulder pain		*[[Chest pain\|Chest]] or shoulder pain
	*Syncope		*[[Syncope]]
	*Dyspnea		*[[Dyspnea]]
	*Diaphoresis		*Diaphoresis
	*Nausea		*[[Nausea]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Management==		==Management==
	*Aspirin, β-blocker, and 1 year of clopidogrel<ref>Saw J, Aymong E, Sedlak T, et al. Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes. Circ Cardiovasc Interv 2014; 7:645.</ref>		*[[Aspirin]], [[beta-blockers\|β-blocker]], and 1 year of [[clopidogrel]]<ref>Saw J, Aymong E, Sedlak T, et al. Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes. Circ Cardiovasc Interv 2014; 7:645.</ref>
	*PCI can be challenging given vessel wall fragility		*PCI can be challenging given vessel wall fragility

Neil.m.young: Text replacement - "beta blocker" to "β-blocker"

2017-08-22T09:00:30Z

Text replacement - "beta blocker" to "β-blocker"

← Older revision		Revision as of 09:00, 22 August 2017
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	==Management==		==Management==
	*Aspirin, ~~beta~~ blocker, and 1 year of clopidogrel<ref>Saw J, Aymong E, Sedlak T, et al. Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes. Circ Cardiovasc Interv 2014; 7:645.</ref>		*Aspirin, β-blocker, and 1 year of clopidogrel<ref>Saw J, Aymong E, Sedlak T, et al. Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes. Circ Cardiovasc Interv 2014; 7:645.</ref>
	*PCI can be challenging given vessel wall fragility		*PCI can be challenging given vessel wall fragility

Alvarez13 at 00:40, 20 March 2017

2017-03-20T00:40:15Z

← Older revision		Revision as of 00:40, 20 March 2017
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	===Causes===		===Causes===
	*Hormonal changes in vessel wall		*Hormonal changes in vessel wall (eg pregnancy, contraceptives)
	*Shear forces		*Shear forces
			*Fibromuscular dysplasia
	*Underling [[connective tissue disorder]]		*Underling [[connective tissue disorder]]

	==Clinical Features==		==Clinical Features==
			*Chest or shoulder pain
			*Syncope
			*Dyspnea
			*Diaphoresis
			*Nausea

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
			*Diagnosis made at time of coronary angiography

	==Management==		==Management==
			*Aspirin, beta blocker, and 1 year of clopidogrel<ref>Saw J, Aymong E, Sedlak T, et al. Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes. Circ Cardiovasc Interv 2014; 7:645.</ref>
			*PCI can be challenging given vessel wall fragility

	==Disposition==		==Disposition==
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	==See Also==		==See Also==
	*[[Chest Pain]]		*[[Chest Pain]]
			*[[ST-segment_elevation_myocardial_infarction_(STEMI)\|STEMI]]

	==References==		==References==