CATHETER ANGIOGRAPHY VERSUS COMPUTED TOMOGRAPHY ANGIOGRAPHY FOR THE DIAGNOSIS OF EXTRACARDIAC FIBROMUSCULAR DYSPLASIA IN PATIENTS WITH SPONTANEOUS CORONARY ARTERY DISSECTION

2016 ◽  
Vol 32 (10) ◽  
pp. S178-S179 ◽  
Author(s):  
E. Rayner-Hartley ◽  
T. Verma ◽  
A. Starovoytov ◽  
M. Heydari ◽  
J. Saw
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Computed Tomography Angiography ◽  
Fibromuscular Dysplasia ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Catheter Angiography ◽  
Coronary Artery Dissection

scholarly journals Spontaneous coronary artery dissection: Acute findings on coronary computed tomography angiography

2018 ◽  
Vol 8 (5) ◽  
pp. 467-475 ◽  
Author(s):  
Marysia S Tweet ◽  
Nila J Akhtar ◽  
Sharonne N Hayes ◽  
Patricia JM Best ◽  
Rajiv Gulati ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Intramural Hematoma ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Coronary Computed Tomography ◽  
Luminal Stenosis

Background: The coronary computed tomography angiography features of acute spontaneous coronary artery dissection, an important cause of acute coronary syndrome in young women, have not been assessed. Methods: The “Virtual” Multicenter Mayo Clinic Spontaneous Coronary Artery Dissection Registry was established in 2010 and includes retrospective and prospective patient data. Retrospective assessment of acute coronary computed tomography angiography images was performed for 14 patients (16 vessels) who had images performed within two days of invasive coronary angiography diagnosis of acute spontaneous coronary artery dissection. Results: Four pertinent diagnostic coronary features of acute spontaneous coronary artery dissection were observed in order of prevalence: 1) abrupt luminal stenosis (64%); 2) intramural hematoma (50%); 3) tapered luminal stenosis (36%); and 4) dissection (14%). Additional findings include epicardial fat stranding (42%), coronary tortuosity (29%), and coronary bridge (14%). Fifty percent of patients had myocardial hypoperfusion in the myocardial distribution of the dissected coronary artery. Conclusions: We define key coronary computed tomography angiography features of acute spontaneous coronary artery dissection, the most common of which are abrupt luminal stenosis and intramural hematoma. Importantly, intramural hematoma appears similar to noncalcified atherosclerotic plaque, emphasizing the importance of invasive coronary angiography for acute diagnosis of spontaneous coronary artery dissection until the sensitivity and specificity of coronary computed tomography angiography is better understood.

Spontaneous coronary artery dissection: how often do we miss this diagnosis? The role of cardiac computed tomography angiography

2019 ◽  
Vol 15 (5) ◽  
pp. 333-338 ◽  
Author(s):  
Giuliana Capretti ◽  
Satoru Mitomo ◽  
Manuela Giglio ◽  
Antonio Colombo ◽  
Alaide Chieffo
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Young Women ◽  
Computed Tomography Angiography ◽  
Cardiac Computed Tomography ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Cardiac Computed Tomography Angiography

Spontaneous coronary artery dissection (SCAD) is an important cause of acute coronary syndrome particularly among young women. Although coronary angiogram (CAG) is the gold standard exam for the diagnosis, SCAD may be missed by CAG alone. Our case series illustrates the adjunctive role of cardiac computed tomography angiography (cCTA) to CAG in ascertaining the diagnosis of SCAD. Three young women were admitted with ST-segment elevation myocardial infarction. CAG showed no significant coronary artery stenosis. In two patients, cCTA performed after CAG revealed an intramural hematoma compressing the coronary lumen. In one patient, SCAD was initially misdiagnosed as Takotsubo cardiomyopathy and cCTA performed 1 month later allowed to make the correct diagnosis of SCAD assessing the spontaneous healing of the dissected vessel.

scholarly journals Spontaneous coronary artery dissection: challenges of coronary computed tomography angiography

2017 ◽  
Vol 7 (7) ◽  
pp. 609-613 ◽  
Author(s):  
Mackram F Eleid ◽  
Marysia S Tweet ◽  
Phillip M Young ◽  
Eric Williamson ◽  
Sharonne N Hayes ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Computed Tomography Angiography ◽  
Invasive Coronary Angiography ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Cardiac Computed Tomography Angiography ◽  
Coronary Syndrome

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.

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