The goal of treatment for spontaneous coronary artery dissection is to repair the tear in your damaged artery and restore blood flow to your heart.
Which treatments are best for you will depend on your situation, including the size of the tear in your artery and its location, as well as any signs or symptoms you're experiencing. Whenever possible, doctors allow the damaged artery to heal on its own, rather than repairing it through invasive procedures.
After spontaneous coronary artery dissection, your doctor may recommend medications to restore blood flow to your heart. Medications can include:
- Blood-thinning drugs. Drugs that reduce the number of blood-clotting platelets in your blood (anticoagulants) reduce the risk of a clot forming in your torn artery.
- Blood pressure drugs. Drugs used to treat high blood pressure can lower your heart's demand for blood, reducing the pressure in your damaged artery. You may continue to take blood pressure drugs indefinitely to reduce the risk of another spontaneous coronary dissection.
For some people, medications may relieve symptoms of spontaneous coronary artery dissection. In these situations, it may be possible to forgo further treatment. If chest pain or other symptoms persist, other treatments may be needed.
Placing a stent to hold the artery open
If your spontaneous coronary artery dissection has blocked blood flow to your heart or if medications don't control your chest pain, your doctor may recommend placing a tiny mesh tube (stent) inside your artery to hold it open. A stent helps restore blood flow to your heart.
To position the stent, doctors insert a long, thin tube (catheter) into an artery — usually in your leg or arm — and thread the tube to the arteries in the heart. The catheter is guided to your damaged artery using X-rays or other imaging tests.
A wire with a deflated balloon is passed through the catheter to the tear in the artery. The balloon is then inflated, expanding the stent against your artery walls. The stent is left in place to hold the artery open.
Surgery to bypass the damaged artery
If other treatments haven't worked or if you have more than one tear in an artery, your doctor may recommend surgery to create a new way for blood to reach your heart.
Coronary artery bypass grafting is a procedure that involves removing a blood vessel from another part of your body, such as your leg. That blood vessel is stitched into place so that it diverts blood flow around your damaged artery.
After your treatment for spontaneous coronary artery dissection, your doctor may recommend other types of care to help you recover and to prevent other health problems. These may include:
Aug. 13, 2013
- Undergoing cardiac rehabilitation. Cardiac rehabilitation is a customized program of exercise and education designed to help you recover from a serious heart condition, such as a heart attack caused by spontaneous coronary artery dissection. Cardiac rehabilitation often includes monitored exercise, nutritional counseling, emotional support and education.
- Reviewing your family medical history. Some inherited conditions, such as the connective tissue disease Marfan syndrome, have been found to occur in people who experience spontaneous coronary artery dissection. Your doctor may refer you to a genetic counselor to review your family medical history and determine whether genetic testing may be right for you.
- Looking for weaknesses in other blood vessels. Your doctor may recommend using CT scanning to look for weaknesses and abnormalities in other blood vessels, such as those in your neck and abdomen.
- Tweet SM, et al. Clinical features, management and prognosis of spontaneous coronary artery dissection. Circulation. 2012;126:579.
- Vrints CJM. Spontaneous coronary artery dissection. Heart. 2010;806:91.
- Alfonso F, et al. Spontaneous coronary artery dissection: Long-term follow-up of a large series of patients prospectively managed with a "conservative" therapeutic strategy. JACC: Cardiovascular Interventions. 2012;5:1062.
- Glamore MJ, et al. Spontaneous coronary artery dissection. Journal of Cardiac Surgery. 2012;27:56.
- Ito H, et al. Presentation and therapy of spontaneous coronary artery dissection and comparisons of postpartum versus nonpostpartum cases. American Journal of Cardiology. 2011;107:1590.
- Don't take a chance with a heart attack: Know the facts and act fast. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/public/heart/mi/heart_attack_fs_en.htm. Accessed Jan. 11, 2013.
- NINDS Fibromuscular dysplasia information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/fibromuscular_dysplasia/fibromuscular_dysplasia.htm. Accessed Jan. 10, 2013.
- What is coronary angiography? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/ca. Accessed Jan. 11, 2013.
- What is a stent? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/stents. Accessed Jan. 14, 2013.
- What is coronary artery bypass grafting? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/cabg. Accessed Jan. 14, 2013.
- Coping with feelings. American Heart Association. http://www.heart.org/HEARTORG/Conditions/More/CardiacRehab/Coping-with-Feelings_UCM_307092_Article.jsp. Accessed Jan. 14, 2013.
- Hayes SN (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 17, 2013.
- What is cardiac rehabilitation? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/rehab. Accessed Jan. 21, 2013.