Spontaneous coronary artery dissection risk factors

The risk factors for spontaneous coronary artery dissection include predisposing factors ( vasculopathy, pregnancy, connective tissue disorder, systemic inflammation) and precipitating stressors (e.g., strenuous exercise, emotional stress, recreational drugs).Features that raise the index of suspicion for SCAD include myocardial infarction in young women (age ≤50), absence of traditional cardiovascular risk factors, little or no evidence of coronary atherosclerosis, peripartum state, history of fibromuscular dysplasia, history of connective tissue disorder or systemic inflammation.

• The phenotypic manifestation of spontaneous coronary artery dissection (SCAD) may occur as a result of predisposing factors compounded by precipitating stressors.^[1]
• The presence of either predisposing or precipitating factors increases the risk of developing a dissection.
• The potential risk factors for SCAD include:^[2][3][4]

• After adjusting for cardiovascular risk factors, predisposing arteriopathies, precipitating stressors, medications, and revascularization, hypertension increased the risk of SCAD recurrence by 2.5 times, whereas beta-blocker usage reduced the recurrence risk by 64%.^[5]