Management depends upon the presenting symptoms. In most people who are hemodynamically stable without high-risk<unk>  involvement, conservative medical management with blood pressure control is recommended. In these people, especially if angiography demonstrates adequate<unk>  flow, the most likely course usually leads to<unk>  healing, often within 30 days. Anti-coagulation should be discontinued upon diagnosis of<unk>  on<unk>  angiography as continuation of anti-coagulation may lead to hematoma and<unk>  propagation. In cases involving high-risk<unk> es, hemodynamic instability, or a lack of improvement or worsening after initial attempts at treatment, urgent treatment with<unk>  stents or<unk>  artery bypass surgery may be necessary. Stents carry the risk of worsening the<unk>  or have an increased risk of other complications as the vessel walls in<unk>  are already weak due to the disease before introducing the stent. Large studies into<unk>  artery bypass surgery are lacking, but this approach is used to redirect blood to the heart around the affected area for cases involving the left main<unk>  artery or when other approaches fail. Angina, or chest pain due to<unk>  insufficiency may persist for months after<unk> , sometimes even when repeat angiography shows vessel healing. Anti-anginal agents such as nitrates, calcium channel blockers and ranolazine are indicated as anti-anginal pharmacologic agents after<unk> . Control of hypertension is also indicated after<unk> , with beta blockers especially showing a reduction in the recurrence of<unk> . Statins are not recommended in the treatment post-SCAD (in the absence of other indications for statins) as the myocardial infarctions in<unk>  are not the result of atherosclerotic plaques. Cardiac rehabilitation is recommended for all patients after myocardial infarction due to<unk>  and is associated with a reduction in anginal symptoms increased psychological well being. Dual antiplatelet therapy should be started after percutaneous<unk>  intervention (stents) is used to treat<unk>  and continued for at least 1 year afterwards. Dual antiplatelet therapy during the acute phase and for at least 1 year after medically treated<unk>  may be also used, based on expert consensus. Physical stress is associated with<unk>  recurrence but there are no heart rate, blood pressure or weight exercise parameters that are established in those with<unk> . In general, it is recommended that those with<unk>  avoid isometric exercise, high intensity endurance training, exercising to the point of exhaustion and activities involving a prolonged Valsalva to reduce the risk of<unk>  recurrence. After addressing the<unk> , people are often treated with typical post-heart attack care, though people who are pregnant may need altered therapy due to the possibility of some teratogenic cardiac medications affecting fetal development. Depending on the clinical situation, providers may screen for associated connective tissue diseases.
Spontaneous coronary artery dissection
Subacute bacterial endocarditis
Left ventricular thrombus
Libman–Sacks endocarditis
Coronary artery aneurysm
Nonbacterial thrombotic endocarditis
Coronary steal
Primary ventricular fibrillation