Spontan kranskärlsdissektion kan orsaka akut koronart syndrom. Ovanligt tillstånd som kräver genomtänkt handläggning och mer
forskning
Sammanfattning
Spontaneous coronary artery dissection (SCAD) is a non-traumatic and non-iatrogenic injury occurring in the vessel wall caused by either
a primary intimal dissection or a primary hematoma in the medial layer. SCAD is more common among women than men and accounts for a
small minority of acute coronary syndromes. The causes of SCAD are multifactorial. Peripartum SCAD is most common. Fibromuscular
dysplasia has a strong association with SCAD. As spontaneous healing is common in SCAD and PCI is associated with complications an initial
conservative approach should always be considered. Medical treatment is based on the underlying cause. Beta blockers are recommended to
all patients. The prognosis varies; the highest mortality is reported among women suffering peripartum SCAD. Quality of life is often affected in
SCAD patients and accompanied by a high rate of rehospitalizations. More research which focuses on the underlying causes, optimal
treatment and rehabilitation is needed.