Spontaneous coronary artery dissection: Overview of pathophysiology

The growing use of imaging examinations has led to increased detection of spontaneous coronary artery dissection (SCAD) as a non-atherosclerotic cause of acute coronary syndrome (ACS). Since a greater awareness of pathophysiologic mechanisms has relevant implications in clinical practice, we aim to provide an update to current knowledge of SCAD pathophysiology. We discuss the most common conditions associated with SCAD, including predisposing factors and triggers, and focus on potential mechanisms leading to SCAD development. Furthermore, we report the main genetic research findings that have shed further light on SCAD pathophysiology. Finally, we summarize practical considerations in SCAD management based on pathophysiologic insights.

Automated summary

The increasing use of imaging examinations has led to an increased detection of spontaneous coronary artery dissection (SCAD) as a non-atherosclerotic cause of acute coronary syndrome (ACS). This article aims to provide an updated knowledge of the pathophysiology of SCAD, discussing common conditions associated with SCAD, predisposing factors, triggers, and potential mechanisms leading to its development. It also summarizes the main genetic research findings that have contributed to a better understanding of SCAD pathophysiology and provides practical considerations in SCAD management based on pathophysiological insights.