ArticleCureus2026
Breaking the Algorithm: Unearthing Life-Threatening Multivessel Spontaneous Coronary Artery Dissection (SCAD) After a Negative Observation Unit Workup.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
Spontaneous coronary artery dissection (SCAD) is an underrecognized, non-atherosclerotic cause of acute coronary syndrome (ACS) that disproportionately affects younger women. We present the case of a 34-year-old woman with hypertension who presented to the emergency department with acute chest pain, dyspnea, and vomiting, only one week after a reassuring chest pain evaluation in an observation unit. Prehospital electrocardiography demonstrated arrhythmia with premature ventricular contractions, followed by inferior-lateral ST-T changes on subsequent tracings. These acute findings prompted coronary angiography, which confirmed SCAD. This case highlights that SCAD may occur even after a negative observation-unit evaluation and emphasizes the importance of maintaining a high index of suspicion for SCAD in young women presenting with recurrent ischemic symptoms. In addition, it includes the potential limitations of conventional chest pain algorithms in detecting non-atherosclerotic causes of ACS and calls for potential branchpoints in risk stratification pathways to incorporate additional cardiovascular syndromes.
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