Spontane Koronararteriendissektion

Zusammenfassung

Die spontane Koronararteriendissektion (SCAD) ist eine seltenere, dennoch wichtige Ursache des akuten Koronarsyndroms, bei der es zu verzögertem Fluss im Gefäß durch die Bildung eines Hämatoms in der Wand der Koronararterie kommen kann. Anders als bei der atherosklerotischen koronaren Herzkrankheit ist die SCAD vor allem bei Frauen im mittleren Lebensalter prävalent. Die aktuellen Leitlinien der European Society of Cardiology (ESC) empfehlen für die allermeisten Fälle ein konservatives Vorgehen mit einer medikamentösen Therapie, die der des allgemeinen akuten Koronarsyndroms entspricht. Bei einer hohen Rate an Spontanheilungen unter dieser Therapie ist die Prognose insgesamt durch eine niedrige Letalität gekennzeichnet.

Abstract

Spontaneous Coronary Artery Dissection (SCAD) is a rare but yet important cause for myocardial infarction. In SCAD, the vessel’s flow is reduced by a hematoma within the artery’s wall. Different from arteriosclerotic coronary artery disease, SCAD is mostly prevalent in middle-aged women. The current guidelines of the European Society of Cardiology (ESC) recommend a conservative approach for most cases. With a high rate of spontaneous coronary healing, the prognosis of SCAD is characterized by a low overall mortality.

Was ist wichtig?

• Die spontane Koronararteriendissektion (SCAD) ist eine seltenere, aber relevante Ursache für akute Koronarsyndrome.

• Die aktuellen Leitlinien der European Society of Cardiology (ESC) betonen den Stellenwert einer konservativen medikamentösen Therapie.

• Eine interventionelle oder chirurgische Revaskularisation wird nur in begründeten Ausnahmefällen empfohlen.

Schlüsselwörter

Myokardinfarkt - akutes Koronarsyndrom - spontane Koronardissektion

Keywords

acute coronary syndrome - myocardial infarction - spontaneous coronary artery dissection

Publication History

Article published online:
05 April 2024

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