Spontaneous Coronary Artery Dissection: Recognition, Triage, and Management in the Emergency Department

Abstract

I had the opportunity to read the article “Spontaneous Coronary Artery Dissection: Recognition, Triage, and Management in the Emergency Department.”1Hickox BC Mikshowsky JA (2016). Spontaneous coronary artery dissection: recognition, triage, and management in the emergency department.J Emerg Nurs. 2016; 42: 301-305Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar I found this article very interesting, and having worked as an ED nurse for 6 years, I am always interested in learning more about proper management of cardiac emergencies. One of the passions I have found in the emergency department is coronary emergencies, including spontaneous coronary artery dissections (SCADs). I appreciate the information you provided on signs and symptoms of SCADs, particularly the information regarding the substantial number of patients with SCAD who present with ventricular dysrhythmia. Addison et al2Addison D Brammer J Gupta S Lakkis N Postpartum spontaneous coronary dissection presenting with ventricular fibrillation.J Cardiol Cases. 2011; 3: e17-e21Abstract Full Text Full Text PDF Scopus (3) Google Scholar also discuss the fact that ventricular dysrhythmia is a presentation of SCAD in patients. Per Addison et al,2Addison D Brammer J Gupta S Lakkis N Postpartum spontaneous coronary dissection presenting with ventricular fibrillation.J Cardiol Cases. 2011; 3: e17-e21Abstract Full Text Full Text PDF Scopus (3) Google Scholar a majority of dissections are attributed to bypass grafts, blunt chest trauma, aortic dissection, and cardiac catheterization. Although this article was very informative, I felt the fact that the majority of patients with SCAD are female as well as being found in those that are young and/or middle-aged.2Addison D Brammer J Gupta S Lakkis N Postpartum spontaneous coronary dissection presenting with ventricular fibrillation.J Cardiol Cases. 2011; 3: e17-e21Abstract Full Text Full Text PDF Scopus (3) Google Scholar This valuable information could be used by frontline nursing staff in the emergency department. Nursing leadership within emergency departments can benefit from this information for current evidence-based practice to pass onto nursing staff within emergency departments. I believe that further study could be performed within emergency departments, specifically county emergency departments, which typically are level I trauma rooms, to collect more data on patients with SCAD. Spontaneous Coronary Artery Dissection: Recognition, Triage, and Management in the Emergency DepartmentJournal of Emergency NursingVol. 42Issue 4PreviewSpontaneous coronary artery dissection (SCAD) has been described as rare, undiagnosed, misdiagnosed, undetected, and overlooked. If a person with no atherosclerotic risk factors presented to your emergency department with symptoms of acute coronary syndrome or after an out-of-hospital cardiac arrest, would you know that SCAD should be considered? Full-Text PDF