Treatment of Fibromuscular Dysplasia Presenting with Spontaneous Coronary Artery Dissection

Clinical scenario

Fibromuscular dysplasia (FMD) is a recognised substrate for spontaneous coronary artery dissection (SCAD). SCAD is an uncommon cause of acute myocardial infarction (AMI) and requires careful assessment before any intervention is pursued.

Approach

When vessel flow is preserved and there is no ongoing documented ischaemia, a conservative (medical) approach is favoured. The regimen addresses haemodynamic stability and risk-factor control — the complete algorithm, including specific agents and sequencing, is available in the full protocol.

Full regimen details, dosing guidance, and decision criteria are accessible via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1177/1358863X18821816

SCAD is an uncommon cause of acute myocardial infarction (AMI).

For these reasons, there is a growing consensus in favor of conservative (medical) management when possible (e.g. TIMI 3 flow in the affected vessel and no ongoing documented ischemia).

Data on optimal medical therapy after SCAD remain limited, with initial evidence suggesting a potential role for beta-blockade and control of hypertension in reducing the recurrence risk.

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