Is coronary dissection painful ?

Reply : Is the coronary dissection actually painful ? As in most conditions of scientific drugs, the reply to the query is, It “might or might not”. However, for some unusual cause, it’s extra typically painless . Thoughts you, even when it happens, it’s atypical, steady, non-anginal if stream is unaffected, and never relieved by nitro-glycerine. This has vital medical significance , as many efficiently lysed STEMI affected person might need minimal segments of dissection/deep plaque fissures. , could also be misdiagnosed as submit infarct angina.

Spontaneous coronary dissection vs Iatrogenic dissection

SCAD is a uncommon , totally different entity , enjoys a preferred house within the patho-physiology of CAD. it’s a dysfunction extra widespread in girls, particularly in being pregnant the place hormones have a tendency to melt the connective tissue in vascular EC matrix. An vital therapeutic warning is PCI is contraindicated in SCAD besides in essential places akin to left predominant.

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Reference

A greatest overview article on SCAD from NEJM Esther S.H. Kim N Engl J Med 2020; 383:2358-2370

Subsequent question

What’s the distinction between plaque fissure and coronary arterial dissection? Is plaque fissure painful ?

Reply couldn’t be synthesised with the accessible cardiac literature.