Perception and experience of spontaneous coronary artery dissection in Spain. Results of a national survey

To the Editor, Spontaneous coronary artery dissection (SCAD) is a low incidence disease that can cause acute coronary syndromes.1,2 Although substantial advances have been made in the knowledge of the physiology, diagnosis, clinical management, and prognosis of SCAD, the degree to which such knowledge has entered the medical community is still uncertain. For this reason, it was decided to conduct a descriptive research on the knowledge and attitude of the Spanish interventional cardiologists towards SCAD. The authors developed a 24-question survey including the clinical presentation, diagnosis, and acute and postcritical management of SCAD.3 The initiative was approved and supported by the Working Group on Hemodynamics and Interventional Cardiology of the Spanish Society of Cardiology. The survey was closed in December 2018 with 161 answers from 72 centers (26 respondents did not complete the variable "center"). Figure 1 shows the answers given to the question "diagnosis". Two thirds of the respondents associated the SCAD with the profile of a young woman without any risk factors or pregnancy/puerperium- related. Regarding the angiographic manifestation, the most common pattern recognized by the respondents was not an angiographic dissection, but the loss of diffuse caliber in the blood vessel (type 2). Also, most respondents reported a low use...