Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir最新文献

{"title":"Artificial Intelligence-Enhanced Risk Stratification in Non-ST-Segment Elevation Myocardial Infarction: The Incremental Prognostic Value of the Modified Glasgow Prognostic Score in Predicting 36-Month Mortality.","authors":"Ertan Aydın, Fatih Özçubukcu, Devrim Kurt, Gökhan Gök, Aslı Vural","doi":"10.5543/tkda.2026.25442","DOIUrl":"10.5543/tkda.2026.25442","url":null,"abstract":"<p><strong>Objective: </strong>Current clinical guidelines for non-ST-segment elevation myocardial infarction (NSTEMI) emphasize the duration of dual antiplatelet therapy (DAPT) based on scores such as the Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) score and the Dual Antiplatelet Therapy (DAPT) score. However, these anatomical and clinical models often overlook the \"inflammatory gap,' namely the contribution of systemic inflammation to both thrombotic and hemorrhagic risk. Although traditional models focus primarily on anatomical complexity, systemic inflammation may serve as a silent driver of adverse outcomes. We aimed to evaluate, using an artificial intelligence (AI)-enhanced approach, the incremental prognostic value of the inflammation-based Modified Glasgow Prognostic Score (mGPS) over a 36-month follow-up period, with particular emphasis on capturing non-linear interactions between biological markers and long-term outcomes.</p><p><strong>Method: </strong>This study included 456 NSTEMI patients who underwent percutaneous coronary intervention (PCI). mGPS, DAPT, and PRECISE-DAPT scores were calculated for all patients. Prognostic performance was assessed using a Gradient Boosting Machine (GBM)-based machine learning (ML) framework. Analyses focused on improvements in the concordance index (C-index), Net Reclassification Index (NRI), and Integrated Discrimination Improvement (IDI), as well as three-year mortality assessed using Cox proportional hazards modeling to identify residual inflammatory risk. Model calibration was evaluated using the Brier score.</p><p><strong>Results: </strong>At 36 months, mGPS emerged as the strongest independent predictor of mortality. Compared with patients with mGPS 0, those with mGPS 2 demonstrated a 6.18-fold higher risk of mortality (hazard ratio 6.18; 95% confidence interval 2.95-12.94; P < 0.001). Observed mortality rates increased markedly from 3.2% in the mGPS 0 group to 57.1% in the mGPS 2 group (P < 0.001). While mGPS was not significantly associated with the ischemic DAPT score (P = 0.349), it was strongly associated with high bleeding risk (PRECISE-DAPT ≥ 25), with all patients in the mGPS 2 category classified as high bleeding risk (P < 0.001). Incorporation of mGPS into the baseline AI model significantly improved discriminative performance, increasing the C-index from 0.72 to 0.81 (P = 0.008). Additionally, the model correctly reclassified 46% of patients (NRI 0.46, P < 0.001) and demonstrated significant predictive improvement (IDI 0.08, P = 0.004) compared with traditional scoring systems.</p><p><strong>Conclusion: </strong>Systemic inflammation, as quantified by mGPS, is a critical biological modifier of cardiovascular risk that may help bridge the \"inflammatory gap\" in current scoring systems. AI-driven integration of mGPS into conventional clinical scores significantly improves 36-month prognostic reclass","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"588-595"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inappropriate Shocks Caused by Implantable Cardioverter-Defibrillator Lead Malposition.","authors":"Uğur Canpolat","doi":"10.5543/tkda.2026.59390","DOIUrl":"10.5543/tkda.2026.59390","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"629-630"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Echocardiography: Five Clinical Challenges and a Roadmap Toward Responsible Integration by 2030.","authors":"Fatih Aydın","doi":"10.5543/tkda.2026.30071","DOIUrl":"10.5543/tkda.2026.30071","url":null,"abstract":"<p><p>Artificial intelligence (AI)-enabled echocardiography has demonstrated strong agreement with expert measurements across a broad range of cardiac functional parameters. However, the transition from technical validation to clinical impact remains incomplete. This structured narrative review employed a systematic literature search to identify the principal structural barriers to AI integration in echocardiography and to develop an expert-informed, evidence-grounded perspective on the priorities for responsible implementation by 2030. The methodological heterogeneity of the included studies, including retrospective and prospective designs, diverse outcome measures ranging from measurement agreement to workflow implementation, and multiple AI application domains, precluded quantitative pooling. Therefore, qualitative synthesis was selected as the primary prespecified analytical approach. PubMed/MEDLINE was searched for studies published between January 2015 and January 2026 addressing clinical AI applications, real-world validation, implementation science, and governance. Forty-six studies meeting predefined inclusion criteria underwent qualitative synthesis. Five interdependent domains were identified: reproducibility across clinical settings, generalizability beyond development datasets, the lack of outcome-focused evidence, regulatory and governance immaturity, and insufficient trust among clinicians and patients. Automated measurements of left ventricular function, strain, and valvular disease severity demonstrate close agreement with expert assessments. However, few studies have shown that AI-assisted echocardiography translates into improved patient outcomes. Based on the available evidence, the principal translational barrier appears to be not algorithmic capability itself, but rather the structural requirements necessary for accountable clinical integration. An expert-informed, evidence-grounded roadmap emphasizing decision-level reproducibility, rigorous external validation, outcome-linked evidence generation, continuous lifecycle governance, and human-centered design is proposed to guide the integration of AI into echocardiography and to support the development of a more durable and accountable clinical infrastructure by 2030.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"547-560"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Patients' Awareness of Anticoagulant Use in Atrial Fibrillation: A Cross-Sectional Survey.","authors":"Fidan Pirmammadova, Hakan G Kalp Uzun, Aytan Mammadli, Ahmet Can Urganc, Yasaman Borna, Arzu Rzayeva, Mehdi Zoghi, Meral Kayıkçıoğlu, Evrim Şimşek","doi":"10.5543/tkda.2026.23942","DOIUrl":"10.5543/tkda.2026.23942","url":null,"abstract":"<p><strong>Objective: </strong>Atrial fibrillation (AF) increases thromboembolic risk, and oral anticoagulants (OACs) substantially reduce this risk; however, their safe and effective use requires adequate patient knowledge. We aimed to assess AF- and OAC-related awareness among Turkish patients and to identify predictors of knowledge.</p><p><strong>Method: </strong>This single-center, cross-sectional survey was conducted between July 1, 2024 and January 1, 2025, and included consecutive adults with non-valvular AF receiving warfarin or direct OACs for at least three months. A structured questionnaire collected data on demographic characteristics, comorbidities, medication use, adherence, and knowledge across six domains: arrhythmia name, treatment indication, dosing schedule, side effects, drug and food interactions, and consequences of dose modification. A composite knowledge score (range, 0���6) was calculated. Multivariable linear regression was used to evaluate predictors of knowledge, including age, sex, and education level. Ethics approval was obtained, and all participants provided written informed consent.</p><p><strong>Results: </strong>A total of 261 patients were included (median age, 67 years; 50.2% women). Hypertension and diabetes mellitus were present in 64.8% and 32.2% of patients, respectively. Direct oral anticoagulants (DOACs) accounted for 72.4% of prescriptions, whereas 27.6% of patients received warfarin. Although 36% of participants had AF for more than six years, only 16.5% could correctly name their arrhythmia. While 92% knew they were taking an anticoagulant, 24% misunderstood its indication. Knowledge of side effects was limited, with 68% reporting no awareness. Awareness of interactions was poor: 88% reported no knowledge of drug���drug interactions, and 71% were unaware of food interactions. Most patients knew their dosing schedule (92.3%) and reported that they would not double a missed dose (99.6%). Self-reported adherence was high (94% 'always' and 4% 'often'), and taking medication with meals was associated with better adherence (���� = 17.0, P < 0.001). The mean knowledge score was 2.8 +- 1.3 (Cronbach's �� = 0.50). Higher educational attainment and female sex were associated with greater knowledge, whereas age was inversely associated with knowledge.</p><p><strong>Conclusion: </strong>Despite high self-reported adherence, substantial knowledge gaps persist among patients receiving anticoagulation for AF, particularly regarding side effects and drug or food interactions. Targeted, health-literacy-sensitive educational strategies may improve medication safety and clinical outcomes in patients receiving anticoagulation for AF.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"606-615"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Carbon Monoxide Poisoning a Potential Trigger for Spontaneous Coronary Artery Dissection? A Case Report and Review of the Literature.","authors":"Selim Süleyman Sert, Sebahat Ulusan, Mevlüt Serdar Kuyumcu","doi":"10.5543/tkda.2025.11859","DOIUrl":"10.5543/tkda.2025.11859","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) is a rare but potentially fatal cause of acute coronary syndrome (ACS), often associated with younger individuals and women without traditional cardiovascular risk factors. Carbon monoxide (CO) poisoning, a known cause of systemic hypoxia, has been implicated in various cardiovascular complications; however, its role in triggering SCAD remains scarcely reported. We present the case of a 55-year-old woman who developed SCAD following acute CO poisoning caused by a domestic gas leak. The patient presented with altered mental status and respiratory failure, requiring hyperbaric oxygen therapy. Following stabilization, typical anginal symptoms emerged, with rising cardiac biomarkers suggestive of myocardial injury. Coronary angiography revealed spontaneous dissections in both the distal left anterior descending artery and the distal right coronary artery without critical flow limitation. The patient was managed conservatively with medical therapy and remained asymptomatic at six month follow-up. This case highlights the importance of considering SCAD in patients presenting with cardiac symptoms following CO poisoning and underscores the need for vigilance in atypical presentations of myocardial injury.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"616-621"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Frontal QRS-T Angle: Toward Integrated Cardiovascular Phenotyping in Acute Ischemic Stroke.","authors":"Çağlar Kaya, Mustafa Ebik, Merve Akbulut Çakır","doi":"10.5543/tkda.2026.84960","DOIUrl":"10.5543/tkda.2026.84960","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"633-634"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Myocardial Contraction Fraction for One-Year Cardiac Death After Transcatheter Aortic Valve Implantation in Severe Aortic Stenosis: A Simple Echocardiographic Metric for High-Risk Stratification.","authors":"Şenol Coşkun, Didar Mirzamidinov, Kurtuluş Karaüzüm, Selma Kenar Tiryakioğlu, Tayfun Şahin, Teoman Kılıç","doi":"10.5543/tkda.2026.74491","DOIUrl":"10.5543/tkda.2026.74491","url":null,"abstract":"<p><strong>Objective: </strong>Myocardial contraction fraction (MCF) is a volumetric index of myocardial shortening that relates left ventricular stroke volume to myocardial volume. In patients with severe aortic stenosis (AS), left ventricular ejection fraction (LVEF) may remain preserved despite advanced myocardial remodeling. This study aimed to evaluate the prognostic value of MCF for predicting 1-year cardiac death in patients undergoing transcatheter aortic valve implantation (TAVI).</p><p><strong>Method: </strong>This retrospective, single-center study included 419 consecutive patients with severe AS who underwent TAVI at a tertiary center. MCF was calculated by dividing stroke volume by left ventricular myocardial volume and multiplying the result by 100. Left ventricular myocardial volume was derived by dividing left ventricular myocardial mass by the myocardial density, which was assumed to be 1.05 g/mL. The primary endpoint was 1-year cardiac death. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal MCF cutoff value, and the patients were divided into low- and high-MCF groups according to this threshold.</p><p><strong>Results: </strong>The ROC-derived MCF cutoff value for predicting 1-year cardiac death was 24%, with an area under the curve of 0.783 (95% CI, 0.716-0.851), a sensitivity of 78.1%, and a specificity of 71.8%. Patients with MCF≤24% had lower LVEF and stroke volume index values, higher myocardial mass index and pulmonary artery pressure values, and larger left ventricular diameters than those with MCF>24%. One-year cardiac death occurred in 32 patients (7.6%) and was significantly more frequent in the MCF≤24% group than in the MCF>24% group (18.7% vs. 2.5%; P < 0.001). In univariable Cox regression analysis, MCF≤24% was strongly associated with 1-year cardiac death. In multivariable analysis, higher MCF, evaluated as a continuous variable, remained independently associated with a lower risk of 1-year cardiac death.</p><p><strong>Conclusion: </strong>Reduced MCF was associated with adverse left ventricular remodeling and increased 1-year cardiac death after TAVI. MCF may provide additional prognostic information beyond conventional echocardiographic parameters in patients with severe AS undergoing TAVI.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"561-569"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age Phenotypes, Angiographic Complexity, and Inflammatory-Metabolic Profiles in First-Presentation STEMI.","authors":"Muhammed Esad Çekin, Salih Vahit Kiriş, Zeliha Aybala Sağlam, İbrahim Güven, Ahmet Emre Akbaba","doi":"10.5543/tkda.2026.92829","DOIUrl":"https://doi.org/10.5543/tkda.2026.92829","url":null,"abstract":"<p><strong>Objective: </strong>Age-based comparisons in ST-elevation myocardial infarction (STEMI) often use a binary young-older framework, which may obscure premature non-young disease. We evaluated age-group patterns in measured modifiable risk factors, angiographic complexity, inflammatory-metabolic indices, and in-hospital outcomes in patients presenting with first STEMI.</p><p><strong>Method: </strong>This single-center retrospective study screened 421 STEMI records between January 2019 and May 2026. After exclusions, 150 patients were selected from an eligible pool of 229 using sex-stratified, equal-size quota sampling. The groups were defined as young STEMI (≤45 years), premature non-young STEMI (men 46-55 years, women 46-65 years), and older STEMI (men >55 years, women >65 years). Measured four-component standard modifiable cardiovascular risk factor (SMuRF) burden, angiographic findings, SYNTAX score, systemic immune-inflammation index (SII), hemoglobin-albumin-lymphocyte-platelet score (HALP), C-reactive protein/albumin ratio (CAR), mortality, and major adverse cardiovascular events (MACE) were analyzed. Two multivariable models were used to assess age group and SYNTAX score.</p><p><strong>Results: </strong>Smoking prevalence decreased across groups, whereas diabetes, hypertension, hyperlipidemia, and measured four-component SMuRF burden increased with age. Thrombus was most frequently observed in young STEMI. SYNTAX score, multivessel disease, SYNTAX ≥23, SII, and CAR increased with age, whereas HALP decreased. Non-smoking SMuRF burden distinguished premature non-young STEMI and older STEMI from young STEMI; older STEMI was independently associated with a higher SYNTAX score. No significant differences in mortality or MACE were detected.</p><p><strong>Conclusion: </strong>In this selected cohort, young STEMI was characterized by smoking predominance, a higher prevalence of angiographic thrombus, and lower coronary complexity, whereas older STEMI showed greater measured four-component SMuRF burden, increased coronary complexity, and less favorable inflammatory-metabolic indices. No differences were detected in in-hospital mortality or MACE.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Spontaneous Coronary Artery Dissection Leading to Advanced Heart Failure and LVAD Implantation.","authors":"Yasin Aktaş, Eda Özcan","doi":"10.5543/tkda.2026.17260","DOIUrl":"https://doi.org/10.5543/tkda.2026.17260","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) is an important cause of acute myocardial infarction in women without significant atherosclerotic coronary artery disease. Recurrent SCAD progressing to advanced heart failure requiring durable mechanical circulatory support is exceptionally uncommon. A 45-year-old woman with a mechanical mitral valve prosthesis presented with non-ST-segment elevation myocardial infarction caused by multivessel SCAD involving the circumflex artery (Type 1) and the first obtuse marginal branch (OM1) (Type 2A). Because coronary flow was preserved (TIMI 3), conservative management was adopted. Follow-up angiography demonstrated healing of the OM1 lesion and a stable residual circumflex dissection. Two years later, she presented with anterior ST-segment elevation myocardial infarction. Coronary angiography demonstrated an abrupt, near-total occlusion of the left anterior descending artery, which was considered most compatible with recurrent Type 4 SCAD after alternative diagnoses, including coronary thromboembolism, were excluded. Despite intracoronary vasodilator therapy, persistent ischemia necessitated percutaneous coronary intervention with drug-eluting stent implantation, restoring TIMI 3 flow. Severe left ventricular systolic dysfunction developed despite successful revascularization and optimal medical therapy. During follow-up, the patient underwent implantation of an implantable cardioverter-defibrillator (ICD) for primary prevention and, after recurrent heart failure hospitalizations over 18 months, durable left ventricular assist device (LVAD) implantation as a bridge to heart transplantation. This case demonstrates that angiographic healing after conservatively managed SCAD does not eliminate the risk of recurrence in previously unaffected coronary territories. It underscores the diagnostic challenges of Type 4 SCAD in patients with competing causes of myocardial infarction and illustrates that recurrent SCAD may rarely progress to advanced heart failure requiring durable mechanical circulatory support.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Coronary Artery Dissection: Current Concepts and Clinical Management.","authors":"Ali Kerem Yılmaz, Fuat Polat, Seyedhesamoddin Khatami, Sait Terzi, Ali Nazmi Çalık","doi":"10.5543/tkda.2026.50511","DOIUrl":"https://doi.org/10.5543/tkda.2026.50511","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic, noniatrogenic cause of acute coronary syndrome (ACS) that predominantly affects women, including those of reproductive age. Misdiagnosis as atherosclerotic coronary disease may lead to inappropriate interventions and antithrombotic therapy. This narrative review summarizes consensus statements, registry data, and observational studies published through July 2026 to provide a structured, clinically oriented overview of the diagnosis, acute management, and long-term care of SCAD. Most recommendations are based on observational studies or registry-level evidence; randomized trial data remain limited. A narrative review of the literature was performed using MEDLINE/PubMed, EMBASE, and the Cochrane Library. Search terms included \"spontaneous coronary artery dissection,\" \"SCAD,\" \"fibromuscular dysplasia,\" \"intramural hematoma,\" and related terms. The search was not date-restricted but was updated through July 2026. Priority was given to guideline documents, consensus statements, registries, systematic reviews, and original cohort studies. The review highlights the angiographic recognition of SCAD patterns and the selective use of intravascular imaging in ambiguous cases. A conservative management strategy is preferred in hemodynamically stable patients with preserved distal coronary flow and no objective evidence of ongoing ischemia, given the high rates of spontaneous healing and the risk of iatrogenic dissection. Revascularization may be considered in selected high-risk patients with ongoing ischemia or hemodynamic compromise. Long-term care includes individualized antiplatelet therapy, beta-blockers, extracoronary arteriopathy screening, rehabilitation, and counseling regarding pregnancy and trigger avoidance. This review provides a clinically applicable framework for SCAD diagnosis and management while highlighting persistent evidence gaps in antithrombotic strategies, recurrence prediction, and extracoronary screening.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}