Surgical Management of Spontaneous Coronary Artery Dissection 13 November 2017


Spontaneous coronary artery dissection, which causes acute coronary syndrome and can result in sudden death, is rare; but its true incidence is underestimated, since most patients die suddenly, without diagnosis. The aim of this study was to show the importance of prompt diagnosis and treatment.

In reviewing the records of 5,000 consecutive patients who underwent coronary angiography between January 2001 and August 2006, we found 6 cases of spontaneous coronary artery dissection (an incidence rate of 0.12%). Five patients presented with left main coronary artery dissection and 1 patient, with right coronary artery dissection.

Angioplasty with stenting failed in the patient with right coronary artery dissection. Coronary artery bypass surgery was performed in all patients. The patient with right coronary artery dissection died of sepsis on the 30th postoperative day. The other 5 patients (83.3%) are still free of symptoms, and they had negative results on stress tests at the 6- and 12-month follow-up visits after coronary artery bypass surgery.

The clinical presentation of spontaneous left main coronary artery dissection was similar to that of atherosclerotic disease. However, early diagnosis of spontaneous coronary artery dissection by means of coronary angiography is of paramount importance, because urgent coronary artery bypass grafting can be lifesaving.

Key words: Aneurysm, dissecting/diagnosis/therapy; death, sudden, cardiac/etiology; myocardial ischemia/etiology; pregnancy complications, cardiovascular; puerperal disorders; rupture, spontaneous

Spontaneous coronary artery dissection (CAD), which causes acute coronary syndrome and can result in sudden death, is a rare event. Spontaneous coronary artery dissection has been observed in 3 groups of patients: patients with coronary artery disease, young women during peripartum, and patients with idiopathic disease and no obvious associated factors. The pathogenesis of spontaneous CAD is still unclear.1,2

The clinical presentation of left main coronary artery (LMCA) dissection may be similar to that of a patient with atherosclerotic disease of the LMCA. Early diagnosis and urgent coronary artery bypass grafting (CABG) is lifesaving in patients with LMCA dissection. In this retrospective study, we present an account of our management of spontaneous CAD, and we review the medical literature in order to investigate the potential causes and optimal treatments of this condition. [ ]

Source: Surgical Management of Spontaneous Coronary Artery Dissection

My surgery was done according to the article below.

See also Coronary Bypass Without Opening the Chest


Watch “Mayo Clinic SCAD Research Program Update: 2017” on YouTube




Mayo Clinic SCAD Research Program Presentation A high-point for survivors and those impacted by SCAD was the research presentation which followed at Edward Hospital, Naperville, IL. This year attendees enjoyed meeting and hearing about the latest research findings presented by some of the researchers from the Mayo Clinic SCAD Research Programs (Rochester, MN): Sharonne Hayes, MD: Mayo Clinic SCAD Research Program Team Lead and Chair of our Scientific Advisory Committee Marysia Tweet, MD: Co-creator of Mayo Clinic SCAD Registry, Senior Cardiology/Fellow Jeanne Theis, PhD: Research Scientist in SCAD DNA Research Also attending from Mayo Clinic SCAD Research Program were Jill Boyum (SCAD Research Study Coordinator), Toni Sauber (Medical Secretary) and Brenda Speltz (Clinical Research Coordinator, SCAD Biobank).
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S.C.A.D. 18 June 2017

Mayo Clinic Coronary Conditions

SCAD not just a heart attack

Mayo Clinic SCAD

The above links are just some of those you will find if you would like to know a little more about SCAD.

On the 7th June, Jessica had gone into St. Vincent’s hospital  for the routine pre-admission, before her Total hip replacement the following Wednesday, I had gone to the dental hospital to have some new dentures fitted, intending to go to the hospital afterwards.

Things were not to be as routine as they usually are, throughout the proceedings it was discovered that unbeknown to either of us Jessica had recently had two small heart attacks.

Jessica has Autonomic Dysreflexia and does not experience pain in the same way as I do which is why the slight pains in her chest and left arm were thought nothing of because they seemed such tiny pains.

An EEG, Cardiac ultrasound, CT Angiography later confirmed that a serious event had taken place. For those who know Jessica as soon as she dressed herself after the CT Angiography she shot through even though the Cardiac Specialist had wanted to admit her.

Well, we received a telephone call that evening from a Dr Andrew Jabbour telling madame that she had a very serious condition for which he was arranging an Angiogram the next morning. During the procedure Jessica suffered an incidence of  of Bradycardia which truncated the proceedings though enough information was gathered to make a diagnosis.

They called “code blue” and admitted her and when I arrived she was as chirpy as ever after her latest adventure.

Apparently her event of Spontaneous Coronary Artery Dissection had been totally asymptomatic since it cannot quite be determined when it happened and Jessica recalls no symptoms-


Signs and symptoms of spontaneous coronary artery dissection (SCAD) are the same as symptoms of other types of heart attacks and may include:

  • Chest pain
  • A rapid heartbeat or fluttery feeling in your chest
  • Pain in your arms, shoulders or jaw
  • Shortness of breath
  • Sweating
  • Unusual, extreme tiredness
  • Nausea
  • Dizziness

And I noticed none.

For all anyone seems to guess, for very little information came our way from her medical team, it may have happened a few years ago down to a few hours ago.

Published on Jan 13, 2015

Spontaneous coronary artery dissection (SCAD) is the leading cause of heart attack in women under age 40 and until recently was largely unstudied due to the erroneous belief that it was a rare occurrence. Novel patient-initiated research initiated in 2010 by the multidisciplinary Mayo Clinic SCAD Research Program SCAD is changing that. Mayo Clinic is the leading clinical and research program for SCAD, a cause of heart attack


Published on Aug 29, 2011

Don’t worry — you’re just tired and out of sorts after having your baby. But the chest pain experienced by the woman you’re about to meet was much more than a difficult recovery. She had a heart attack when a rare and deadly condition stopped blood flow to her heart. The same thing happened to another woman. After sharing their stories on social networking sites they found more women with the same problem. That’s when they

Published on Feb 21, 2013

A heart attack at age 35. That’s not supposed to happen. The woman you’re about to meet suffered what’s called a spontaneous coronary artery dissection, or SCAD. It’s a condition that’s hard to diagnose and there’s very little information available about it. Experts at Mayo Clinic have results from studies aimed at learning more about this life-threatening condition.

Jessica’s hip Replacement was cancelled and now she is getting to know the world of SCAD survivors with many appointments to various clinics.