Updates in Spontaneous Coronary Artery Dissection

Chayakrit Krittanawong, Jacqueline Saw, Jeffrey W. Olin

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations


Purpose of Review: To review the epidemiology, pathogenesis, diagnosis using emerging imaging modalities, management strategy, and prevention of recurrent spontaneous coronary artery dissection (SCAD) and provide a more extensive review of the current data. Recent Findings: SCAD generally affects women without conventional cardiovascular risk factors. Diagnosis and management of SCAD are challenging due to heterogeneity, undefined mechanisms, differing phenotypes, and a lack of strong clinical evidence. Summary: After reviewing the current evidence to date, we recommend conservative management, including cardiac rehabilitation for SCAD with low-risk features, while coronary revascularization should be considered in SCAD with high-risk features. Non-invasive imaging (e.g., coronary computed tomography angiography, cardiac magnetic resonance, myocardial perfusion imaging) should be considered in diagnosing specific SCAD phenotypes. The standard guideline-based medical therapy for acute coronary syndrome, in the absence of contraindications, should be considered along with appropriate SCAD phenotypes. Discharge counseling and follow-up using emerging imaging modalities should be based on individuals’ profiles and approached on a case by case basis.

Original languageEnglish
Article number123
JournalCurrent Cardiology Reports
Issue number10
StatePublished - 1 Oct 2020


  • Cardiac rehabilitation
  • Coronary revascularization
  • Recurrent SCAD
  • SCAD
  • SCAD prevention
  • Spontaneous coronary artery dissection


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