Abstract
Spontaneous coronary artery dissection (SCAD) is a life-threatening condition and multiple conditions have been associated with this entity. This study aims to further investigate and characterize the association of the underlying rheumatological disease with SCAD. A comprehensive literature search on four databases was performed using different Medical Subject Headings (MeSH) and all articles on SCAD in association with rheumatological diseases were identified. The analysis was performed using the Statistical Package for Social Sciences (SPSS), v22 (IBM SPSS Statistics, Armonk, NY). Ten articles of SCAD secondary to rheumatological reasons were identified. The majority of presentations were associated with systemic lupus erythematosus (SLE). Most patients presented with a non-ST-elevation myocardial infarction (NSTEMI) involving the left main coronary vessel. The majority of them were successfully managed with stenting. Mortality was less than 20% with prompt identification and management of the SCAD. SLE was the most commonly reported rheumatological condition associated with SCAD. Prompt diagnosis and management of SCAD in such patients can be life-saving.
Highlights
In 1956, Watson first introduced arterial dissection as a condition resulting from blood penetration into the arterial wall, causing a separation between the vessel layers, with or without a tear of the tunica intima [1]
systemic lupus erythematosus (SLE) was the most commonly reported rheumatological condition associated with Spontaneous coronary artery dissection (SCAD)
There are many conditions associated with SCAD, most notably with pregnancy, but little is known about its association with rheumatological and systemic inflammatory conditions
Summary
In 1956, Watson first introduced arterial dissection as a condition resulting from blood penetration into the arterial wall, causing a separation between the vessel layers, with or without a tear of the tunica intima (inner vessel layer) [1]. Spontaneous coronary artery dissection (SCAD) is defined as a tear in the coronary arterial wall resulting in blood dissecting between layers in the absence of atherosclerosis, traumatic, or iatrogenic injury [2]. It was first described by Pretty in a 42-year-old female in 1931 during a postmortem examination [3]. There are many conditions associated with SCAD, most notably with pregnancy, but little is known about its association with rheumatological and systemic inflammatory conditions. This study sought to determine the association of SCAD with rheumatological and systemic inflammatory conditions
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