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Suspect SCAD in younger women with ACS and no atherosclerotic risk
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Confirm diagnosis with coronary angiography or intracoronary imaging
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Avoid thrombolytics due to risk of extension
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Avoid routine PCI unless ongoing ischemia or hemodynamic compromise
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Start conservative medical therapy (beta-blockers, aspirin)
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Manage blood pressure and reduce shear stress
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Evaluate for fibromuscular dysplasia and vascular abnormalities
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Refer to cardiology experienced in SCAD management
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Educate on recurrence risk and need for cardiac rehab
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Schedule follow-up imaging if symptoms recur
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Suspect SCAD in younger women with ACS and no atherosclerotic risk
Confirm diagnosis with coronary angiography or intracoronary imaging
Avoid routine PCI unless ongoing ischemia or hemodynamic compromise
Start conservative medical therapy (beta-blockers, aspirin)
Avoid thrombolytics due to risk of extension
Evaluate for fibromuscular dysplasia and vascular abnormalities
Manage blood pressure and reduce shear stress
Educate on recurrence risk and need for cardiac rehab
Schedule follow-up imaging if symptoms recur
Refer to cardiology experienced in SCAD management
Add a Title
Add a Title
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A 45-year-old woman with no CAD risk factors presents with sudden-onset chest pain. ECG shows anterior ST changes. Troponin is elevated. Angiography reveals coronary dissection without atherosclerosis. What is the stepwise approach to managing SCAD?
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Spontaneous Coronary Artery Dissection (SCAD)
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