Spontaneous coronary artery dissections: Four cases and literature review

Year 2009, Volume: 36 Issue: 4, 294 - 300, 01.12.2009

Necmettin Çolak Yunus Nazlı Fatih Alpay Ömer Çakır

Abstract

Spontaneous coronary artery dissection(SCAD) is a very rare cause of acute coronary syndrome. SCAD can cause stable angina, unstable angina, acute myocardial infarction, cardiogenic shock and sudden cardiac death. Predisposing factors include atherosclerosis, the peripartum period, structural and inflammatory conditions affecting the arterial wall. The diagnosis is usually made by coronary angiography. The clinical presentation is similar to the atherosclerotic coronary artery disease. Prompt diagnosis and treatment of patients improves survival. Therapeutic options include medical therapy, percutaneous coronary intervention and surgery. The four cases were presented an discussed with review of the pertinent literature.

Keywords

Spontaneous coronary artery dissection, acute coronary syndrome, coronary artery disease, coronary artery bypass graft surgery

eçirilmesi

Abstract

Spontan koroner arter diseksiyonu (SKAD), akut koroner sendromun nadir görülen bir sebebidir. SKAD\'ları stabil angina pektoris, unstabil angina pektoris, akut miyokard infarktüsü, kardiyojenik sok ve ani kardiyak ölüme sebep olabilir. Ateroskleroz, peripartum periyod, arter duvarını etkileyen strüktürel ve inflamatuar durumlar predispozan faktörlerdir. Teshis genellikle koroner anjiografi ile konur. Klinik prezentasyon aterosklerotik koroner arter hastalıgı ile benzerdir. Koroner arter diseksiyonlu hastaların teshis ve tedavisinin hızlı yapılması sagkalımı arttırır. Tedavi seçenekleri medikal tedavi, perkütan koroner girisim ve cerrahi tedavidir. Tedavi seçimi hastanın klinigi, etkilenen koroner arter ve diseke segmentin uzunluguna göre karar verilir. Biz SKAD\'u olan ve basarı ile tedavi edilen 4 olgumuzu literatür bilgileri esliginde sunduk.

Keywords

Spontan koroner arter diseksiyonu, akut koroner sendrom, koroner arter hastalıgı, koroner arter bypass greft operasyonu

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