BACKGROUND: There is limited understanding of the role of cardiac computed tomography angiography (CCTA) for assessment of patients with spontaneous coronary artery dissection (SCAD). METHODS: In this report we describe the diagnostic utility of CCTA in three young women presenting with signs and symptoms of myocardial ischemia who were eventually diagnosed with SCAD. RESULTS: None of the women had traditional atherosclerotic risk factors. SCAD was not initially identified on CCTA in any of the three women, but was visualized during retrospective analysis in two patients after invasive coronary angiography. In two patients follow-up CCTA imaging was used successfully for subsequent management. CONCLUSIONS: In patients presenting with signs or symptoms of acute coronary syndrome, SCAD may be missed or not detectable on CCTA. A negative CCTA should not exclude a diagnosis of SCAD, and invasive coronary angiography should be considered for further evaluation.
BACKGROUND: There is limited understanding of the role of cardiac computed tomography angiography (CCTA) for assessment of patients with spontaneous coronary artery dissection (SCAD). METHODS: In this report we describe the diagnostic utility of CCTA in three young women presenting with signs and symptoms of myocardial ischemia who were eventually diagnosed with SCAD. RESULTS: None of the women had traditional atherosclerotic risk factors. SCAD was not initially identified on CCTA in any of the three women, but was visualized during retrospective analysis in two patients after invasive coronary angiography. In two patients follow-up CCTA imaging was used successfully for subsequent management. CONCLUSIONS: In patients presenting with signs or symptoms of acute coronary syndrome, SCAD may be missed or not detectable on CCTA. A negative CCTA should not exclude a diagnosis of SCAD, and invasive coronary angiography should be considered for further evaluation.
Authors: Sharonne N Hayes; Esther S H Kim; Jacqueline Saw; David Adlam; Cynthia Arslanian-Engoren; Katherine E Economy; Santhi K Ganesh; Rajiv Gulati; Mark E Lindsay; Jennifer H Mieres; Sahar Naderi; Svati Shah; David E Thaler; Marysia S Tweet; Malissa J Wood Journal: Circulation Date: 2018-02-22 Impact factor: 29.690
Authors: Marysia S Tweet; Nila J Akhtar; Sharonne N Hayes; Patricia Jm Best; Rajiv Gulati; Philip A Araoz Journal: Eur Heart J Acute Cardiovasc Care Date: 2018-01-29