Gender Differences and Predictors of Mortality in Spontaneous Coronary Artery Dissection: A Review of Reported Cases
Spontaneous coronary artery dissection (SCAD) is a rare but potentially lethal event.1,2 It is a separation between the intimal and medial wall of the coronary vessel. The potential result of the dissection is obstruction of the vessel lumen and subsequent myocardial ischemia. Prior to the widespread use of coronary angiography, diagnosis was made at autopsy.2 From reported cases, some trends have been identified. There are reported associations with female sex,2,3 exercise,4–7pregnancy and postpartum state,8–12 coronary artery disease,2, 13, 14 and connective tissue disorders.9,15,16 The left anterior descending artery is more affected in women; the right coronary artery is more often affected in men.2 Most cases have no identifiable risk factor.17,18 There is little information on etiology, management and outcomes for SCAD. We report two patients with SCAD that highlight the uncertainties surrounding the treatment and diagnosis of this disease. Consequently, we undertook a comprehensive literature review to identify risk factors, treatment strategies and outcomes for this disorder.
Thompson, E. A., Ferraris, S., Gress, T., & Ferraris, V. (2005). "Gender differences and predictors of mortality in spontaneous coronary artery dissection: a review of reported cases". The Journal of Invasive Cardiollogy 17(1), 59-61.