ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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Spontaneous Coronary Artery Dissections: Review
Dr. Hürkan KURŞAKLIOĞLU,a Dr. Atila İYİSOY,a Dr. Sedat KÖSEa
aKardiyoloji AD, GATA, ANKARA
Spontaneous coronary artery dissection is a rare but significant pathology with a potential of leading to acute coronary syndromes. It is relatively more common in young patients and particularly in pregnant women or women at early postpartum period. Approximately 2/3 of the patients are females. All three coronary arteries can be involved; moreover, the most frequently involved coronary artery is the left anterior descending artery.
Clinically, spontaneous coronary artery dissection can present with acute myocardial infarction, stable and unstable anjina pectoris, cardiogenic shock, and sudden cardiac death. Although coronary angiography is the basic technique in the diagnosis, intravascular ultrasound may be used for the definitive diagnosis in presumptive cases. The number of involved coronary vessels is of great importance for the method of revascularization. Cases with single vessel disease can be treated with stenting whereas surgical approach is the preferred therapy in cases with left main coronary disease or multi-vessel disease. However, spontaneous resolution can be observed in some cases. The treatment of acute myocardial infarction caused by spontaneous coronary artery dissection differs significantly from the treatment of myocardial infarction caused by other reasons. Although some researchers consider that thrombolytic therapy is contraindicated, good results with thrombolytics were reported. Hence, recognizing this disorder ensures correct approach to these patients.
In this review, we discuss the diagnosis, pathophysiology, clinical manifestations and recent advances in the treatment of spontaneous coronary artery dissection. In addition, we review the highlight points of stenting in cases with spontaneous coronary artery dissection.Keywords: Coronary vessels, dissection, coronary arteriosclerosis death, sudden, cardiacTurkiye Klinikleri J Med Sci 2006, 26:62-67
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