18^th Annual Cardiologists Conference

Biography

Biography: Amjed Eljaili

Abstract

Spontaneous coronary artery dissection is rare cause of acute coronary syndrome in young female in reproductive period, the mechanism is completely different from common causes of coronary artery atherosclerotic disease. It has been reported that there is a significant link with underline blood vessels disease like fibromuscular dysplasia which is rare condition affect all arteries in the body, most common affected arteries are, renal and carotid artery which characterized by thickening of arterial wall leading to stenosis. Majority of patient affected were found to be female with median age between 20 to 60. The risk increased significantly during pregnancy between 5 to 18%, this ia can be 6 weeks per-partum and post-partum but up to 18 months also reported. Extreme emotional stress and physical exercise like heavy lifting and valsalva type of activity participating in the cause of SCADAS as well. Connective tissue disease like marfan synfrom, Ehler-denlos danols syndrome, systemic lupus erytrpmtpus polyarteritis nodpsa and inflammatory bowels disease can be participator factor for SCAD. The diagnosis of SCAD is a challenge and in most cases establishment of SCAD diagnosis has to be at time of coronary angiogram, intravascular ultrasound and OCT (optical coherence) tomography and IVUS intravascular ultrasound, according to coronary angiogram findings SCAD divided into three types. The management of SCAD in majority of the patients is conservative in form of aspirin , heparin, beta-blocker and ACE inhibitor along with  clopidogrel in some patients, however revascularization by PCI and CABG depending on certain specific criteria. Overall long-term prognosis of SCADA is excellent but there is high risk of recurrence, interestingly recurrence in most cases involves a new coronary artery segment therefore patient with SCAD should always be counselled about the risk of recurrence of this condition.