ABSTRACT
Spontaneous coronary artery dissection (SCAD) is a clinically challenging entity that is an important cause of both acute myocardial ischemia and infarction and sudden cardiac death, especially in women. This chapter examines the prevalence of potential predisposing conditions and demonstrated evidence of fibromuscular dysplasia (FMD) in 72". There are two proposed mechanisms of SCAD. The first includes initiation of medial dissection and hemorrhage by an intimal tear and creation of a false lumen. The second involves the spontaneous development of an intramural hematoma (IMH), potentially due to disruption of the intra-arterial vasa vasorum. OCT has superior spatial resolution that is unparalleled in modern-day commercially available imaging technology. This imaging modality is instrumental in the diagnosis of SCAD cases where angiographic findings are ambiguous for confirming SCAD. Multiple case reports, including our own, have since implicated coronary FMD as a central predisposing arteriopathy in the pathogenesis of SCAD.
