Extremely Heavy Lifting Associated With Spontaneous Coronary Artery Dissection

Abstract

Spontaneous coronary artery dissection (SCAD) is a separation of the intimal wall by intramural hemorrhage and has been classically associated with young women. We report a case of a healthy 58-year-old man who presented with chest pain that arose shortly after lifting machinery that was known to weigh 200-250 pounds. He was admitted with a non-ST elevation myocardial infarction and was later found to have non-atherosclerotic SCAD. No underlying cause was identified, and the patient was managed medically. This case illustrates that physicians should maintain an index of suspicion for SCAD as a cause of acute coronary syndrome even in male patients without diseases associated with the condition, especially when heavy lifting is reported.

Spontaneous coronary artery dissection in patients with prior psychophysical stress: a systematic review of case reports and case series

“…The SCAD-related characteristics are presented in Table 2. All patients reported chest pain as their chief complaint except for three [45,51,97]. Furthermore, 12 (11.4%), 11 (10.5%), and 9 (8.6%) patients experienced nausea, dyspnea, and diaphoresis, respectively.…”

“…(continued) Three cases of multivessel SCAD presented with different types of SCAD in each artery support[16, 37,106], and seven patients were advised to abstain from sports[51, 55, 59,88,97,103]..…”

Diseksi Spontan Arteri Koroner: Diagnosis dan Manajemen

“…Secara keseluruhan SCAD terdapat hubungan dengan FMD, pregnancy, connective tissue disorder, terapi hormonal, penyakit sistemik tetapi faktor risiko jenis kelamin perempuan, kehamilan, dan FMD yang kuat pada banyak penelitian [19], [20]. Pada SCAD dilaporkan terdapat faktor pencetus terjadinya SCAD yaitu latihan berat (baik beban maupun aerobik), stres emosi yang berat, melahirkan, akivitas berhubungan manuver valsava, obat-obatan rekreasi, dan terapi hormonal [20], [21].…”