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CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Spontaneous coronary artery disease: A single center experience
Session:
Posters 2 - Écran 1 - Doença Coronária
Speaker:
Cátia Costa Oliveira
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.1 Acute Coronary Syndromes – Pathophysiology and Mechanisms
Session Type:
Posters
FP Number:
---
Authors:
Cátia Costa Oliveira; Glória Abreu; Isabel Durães Campos; Paulo Medeiros; Carla Rodrigues; João Costa; Carlos Galvão Braga; Jorge Marques
Abstract
<p><strong>Introduction: </strong>Though underestimated, myocardial infarction due to spontaneous coronary artery disease (SCAD) is an increasingly prevalent entity. Nevertheless, there is still a lack of evidence regarding treatment.</p> <p><strong>Aim: </strong>To investigate the characteristics and prognosis of patients with SCAD.</p> <p><strong>Methods:</strong> Single-center, retrospective study performed in patients hospitalized from January 2010 to December 2018 with diagnosis of SCAD (n= 52), regarding patient characteristics and outcomes (death, myocardial infarction, SCAD recurrence and stroke at discharge and during follow-up).</p> <p><strong> Results: </strong>Patients with SCAD were mainly female (78.8%) with median age of 55.6 years. Predisposing factors were identi?ed in 36.5% of patients and precipitating factors in 23.1%. Non-ST elevation myocardial infarction (NSTEMI) was the main form of presentation (65.4%). The left anterior descending artery (LAD) was the most commonly involved (34.5%) and 5 patients had compromise of 2 or more non-contiguous arteries. Type 2 dissection was the most prevalent angiographic pattern (73.1%). Ejection fraction was reduced in 30.8%. The majority of patients (69.2%) were managed medically and the remaining patients underwent percutaneous coronary intervention (PCI) with second generation drug-eluting stents. PCI were mainly due to re-infarction during hospitalization (n=4) or due to the nature of the territories involved (Left main or proximal LAD, n= 4). Eight patients re-infarcted while in the hospital and 5 during follow-up (SCAD was present in 4 patients: in 3 patients the event occurred in a coronary territory other than that of the index case, and in 1 patient it occurred in the previously affected territory). At discharge, 75% of patients were medicated with dual antithrombotic therapy. Over the period of follow-up, 3 patients develop heart failure and there were no registries of death or stroke. Fibromuscular dysplasia and inflammatory/ connective tissue diseases were not investigated in our population. We are currently implementing a protocol with Rheumatology to rule-out these predisposing factors for SCAD. Ten patients were already involved and, in at least 1 patient, an inflammatory disease was diagnosed.</p> <p><strong>Conclusion:</strong> SCAD is mostly associated with young women with low cardiovascular risk. It is important to investigate predisposing factors since SCAD recurrence was not rare. Nevertheless, the prognosis of the disease in our population was good.</p>
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