AUTHOR=Mehmedbegović Zlatko , Ivanov Igor , Čanković Milenko , Perišić Zoran , Kostić Tomislav , Maričić Bojan , Krljanac Gordana , Beleslin Branko , Apostolović Svetlana 

TITLE=Invasive imaging modalities in a spontaneous coronary artery dissection: when “believing is seeing”

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1270259

DOI=10.3389/fcvm.2023.1270259

ISSN=2297-055X

ABSTRACT=Spontaneous coronary artery dissection (SCAD) is a rare but increasingly recognized cause of acute coronary syndrome (ACS) with recent advancements in cardiac imaging facilitating its identification. However, SCAD is still often misdiagnosed due to the absence of angiographic hallmarks in a significant number of cases, highlighting the importance of meticulous interpretation of angiographic findings, and if needed, additional usage of intravascular imaging to verify changes in arterial wall integrity and identify specific SCAD pathoanatomical features. Accurate diagnosis of SCAD is crucial, as optimal management strategies for patients with SCAD differ from those with atherosclerotic coronary disease. Current treatment strategies favour a conservative approach, with intervention reserved for cases with ongoing ischemia, patients with high-risk coronary anatomy or hemodynamic instability. In this paper, we provide a preview of invasive imaging modalities, classical angiographic and intravascular imaging hallmarks that may facilitate proper SCAD diagnosis.