User:Mr. Ibrahem/Spontaneous coronary artery dissection

Spontaneous coronary artery dissection (SCAD) is when one of the arteries that supply the heart develops a separation within it wall that fills with blood. Symptoms are those of a heart attack, with chest pain, shortness of breath, sweating, nausea, and increased heart enzymes. Complications can include heart failure and sudden death.

Risk factors such as pregnancy, fibromuscular dysplasia, connective tissue disorders, and inflammatory conditions, are often present. Triggers may include vomiting, coughing, or emotional stress. The underlying mechanism involves a tear in the inner lining of an artery that supplies the heart, allowing blood to enter and separate the layers of the wall of the artery. This narrows the artery resulting in decrease blood flow. Diagnosis is usually by angiography, though a number of other types of medical imaging may be used.

The best way to manage the condition is not entirely clear. Conservative treatment is generally preferred over percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). Beta blockers and aspirin may be recommended long-term. While the risk of death is less than 5%, some type of surgery is required in 15%, and about 10% recur.

SCAD is uncommon. It is estimated to represent between 0.1% and 4% of acute coronary syndrome cases. Young and middle aged women are most commonly affected. It was first described in 1931 during an autopsy.