A case of spontaneous coronary artery dissection: it is not always plaque rupture

The Journal of Emergency Medicine
Sohil Pothiawala, Fatimah Lateef

Abstract

Spontaneous coronary artery dissection (SCAD) is an extremely rare cause of acute coronary syndrome (ACS). Patients may present with a broad spectrum of clinical scenarios, ranging from angina pectoris to myocardial infarction, cardiogenic shock, and sudden death. Standard therapy has not been established; current treatments range from conservative management to percutaneous revascularization or coronary artery bypass surgery. SCAD greatly mimics ACS, and this diagnosis should be considered when evaluating young patients who present with ACS with or without classical risk factors for coronary artery disease. We report a case of a 45-year old man who presented with chest pain typical of ACS. He had no risk factors except for a smoking history of 2.5 pack-years. Once the clinical findings suggested acute inferolateral myocardial infarction, the patient underwent emergent cardiac catheterization, which revealed left anterior descending coronary artery dissection. This in itself is not a common cause of inferolateral ST elevation changes on electrocardiogram. This case highlights the fact that although SCAD is a rare entity, it is increasingly being recognized as a significant cause of ACS. Urgent angiography should be considered i...Continue Reading

References

Mar 4, 2000·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·D E Cohen, C L Strimike
Aug 18, 2001·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·S K CelikH Kultursay
Feb 28, 2002·Angiology·Rajiv DhawanHenry Fesniak
Nov 8, 2005·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Jonathan Eddinger, William A Dietz
Jun 3, 2008·Cardiovascular Ultrasound·Jayanth R ArnoldAdrian P Banning

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Citations

May 27, 2015·The American Journal of Forensic Medicine and Pathology·İpek Esen MelezBülent Şam

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