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The authors also list some conditions that can mimic SCAD on invasive angiography so, for accurate diagnosis in these cases, the authors suggest other options including intracoronary (OCT) imaging and CT coronary angiography. Issues with diagnosis are covered, including the increased risk of further dissections being caused by angiography. Only around 5-10% of SCADs happen during or after pregnancy (P-SCAD).
![The Pcr Eapci Textbook The Pcr Eapci Textbook](https://www.pcronline.com/var/pcrov3/storage/images/media/pcr/courses/2020/pcr-e-course/illustrations/pcr-e-course-textbook-640x360/12990677-1-eng-GB/pcr-e-course-textbook-640x360_imagefull.jpg)
Incidence of SCAD is, the authors say, hard to estimate due to under- and mis-diagnosis, but estimates range from 0.8-4%.Īround 90% of cases are in women and SCAD accounts for 23-36% of Acute Coronary Syndrome (ACS) in women under 50-60 years of age, with the average age being 50. Click here and here for more on recent research. Progress in the genetics area is discussed, including common and rare genetic variants that are associated with SCAD. ‘Outside in’ suggests that the initial event is a bleed within the artery wall, where an intramural haematoma (bruise) builds up and slows or stops blood flow through the artery. ‘Inside out’ suggests there is a ‘tear’ in the artery wall that allows blood to enter a false lumen that develops between the artery walls, disrupting blood flow. The chapter defines SCAD and discusses two theories for how SCAD occurs, the ‘inside out’ and ‘outside in’ hypotheses. “It’s the first chapter dedicated to SCAD of any textbook of this sort,” said Dr Adlam, who added that the textbook will be continually updated with new information as it emerges. The new chapter in the PCR-EAPCI Textbook Percutaneous Interventional Cardiovascular Medicine, has been written by cardiologists and SCAD experts Dr David Adlam, who is leading the SCAD research in Leicester, Fernando Alfonso from Spain, Angela Maas from The Netherlands, Alexandre Persu and Christiaan Vrints from Belgium. This is great news for the SCAD community as it provides up-to-date information about SCAD, its diagnosis, management and aftercare to interventional cardiologists. A textbook for interventional cardiologists now includes a chapter on SCAD.
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