What Is the Treatment for Coronary Artery Dissection?
Coronary artery dissection is a recognised cause of acute coronary syndrome. In clinically stable patients without objective evidence of ongoing ischaemia, conservative management with medical therapy is the generally preferred strategy, associated with favourable outcomes in retrospective observational data.
Treatment Approach
Conservative medical therapy is the cornerstone of management. Long-term antiplatelet treatment is a central component of the regimen — additional cardiac medications are selected based on the patient's specific clinical and haemodynamic profile.
Full regimen, sequencing, and specific indications available via the structured protocol below.Treatment Goal
The primary objective is angiographic healing of the coronary artery dissection. Healing can be detected within days and is frequently observed by one month.
References
DOI: 10.1161/cir.0000000000000564
- In summary, on the basis of the retrospective observational data cited above, conservative therapy is generally the preferred strategy in patients with SCAD who are clinically stable and without objective evidence of ongoing ischemia and has generally been associated with favorable outcomes.
- Most experts recommend aspirin use for at least 1 year and frequently indefinitely after SCAD in patients who receive medical treatment, in the absence of contraindications.
- β-Blockers should be considered in patients with SCAD who have LV dysfunction or arrhythmias and for management of hypertension.
- After SCAD, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers should be used when MI is complicated by LV systolic dysfunction, according to national guidelines for the management of patients after MI.
- The time course of healing remains uncertain, but it can be detected within days and is frequently observed by 1 month.