Spontaneous coronary artery dissection in young women

Almahmeed, Wael; Haykowski, M.; Boone, John A.; He, Ling; Allard, M.; Webb, John G.; Carere, Ronald G.

doi:10.1002/(sici)1097-0304(199602)37:2<201::aid-ccd21>3.0.co;2-l

Cited by 38 publications

(34 citation statements)

References 17 publications

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“…Nine of these patients were male and the mean age at the time of dissection was 36 years of age ranging from 17 to 53 years. The risk factors each patient had were analyzed; 30.7% were smokers, 30% had high cholesterol and 15.3% had a family history of ischemic heart disease [1,[3][4][5][6][7][8][9][10][11][12]. Obesity was identified as a further risk factor in one of these patients [5].…”

Section: Discussionmentioning

confidence: 99%

Exercise-induced coronary artery dissection in a 54-year-old male without atherosclerosis: A case report

Ellis¹,

Grey²,

D'Sa³

et al. 2016

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.comExercise-induced coronary artery dissection in a 54-year-old male without atherosclerosis: A case report Paul Ellis, Victoria Grey, Anthony D'Sa, Derek Connolly ABSTRACT Introduction: Spontaneous coronary artery dissection (SCAD) is an unusual cause of chest pain most often presenting in peripartum or postpartum women. The SCAD precipitated by exercise in patients without underlying atherosclerosis is very rare and has been described in literature only on a few occasions. It has never been described in a male above the age of 40. Case Report: We present the case of a 54-year-old male presented with acute ST elevation myocardial infarction having suffered a left anterior descending artery dissection following an intense gym workout. He was successfully managed with coronary stenting. The patient suffered from on-going chest pain after initial recovery and was investigated with CT coronary angiography to assess stent patency and for evidence of underlying coronary artery disease. This showed a calcium score of 0 and no evidence of underlying atherosclerosis with a patent stent. Conclusion:In conclusion, SCAD should be considered in the differential diagnosis of patients presenting with acute coronary syndrome, even those without coronary risk factors.

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Section: Discussionmentioning

confidence: 99%

Exercise-induced coronary artery dissection in a 54-year-old male without atherosclerosis: A case report

Ellis¹,

Grey²,

D'Sa³

et al. 2016

IJCRI

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“…3)4) Although SCAD has been reported to occur in association with pregnancy or during the early postpartum period, 5) oral contraceptives, 6) intense physical exertion, [7][8][9] blunt chest trauma, 10) connective tissue disorder, such as Marfan's or Ehlers-Danlos syndromes, 11) and various immune or inflammatory disease, such as autoimmune thyroditis, 12) and We think SCAD needs to be included as a possible differential diagnosis in patients with chest pain. This is the first report of a patient of SCAD presenting as variant angina, which rapidly progressed during an ergonovine test.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Coronary Artery Dissection Manifested during Ergonovine Test and Treated with Intravascular Ultrasound Guided Stenting: A Case Report

et al. 2005

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Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute myocardial ischemia, which frequently presents as sudden death. The pathophysiology and treatment of SCAD have not been fully determined. Herein, a case of SCAD, manifesting as variant angina, which rapidly progressed during an ergonovine test, in which 3 drug-eluting stents were deployed using intravascular an ultrasound guidance, with an excellent immediate result, is reported. (Korean Circulation J 2005 ; 35 : 264-268) KEY WORDS：Spontaneous coronary artery dissection；Ergonovine stress；Intravascular ultrasonography；Drug-eluting stent.

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“…Other conditions associated with SCAD include the following: systemic lupus erythematosis, 48 hypersensitivity angiitis, 37, 49 blunt chest trauma, [50][51][52][53] intense physical exercise, [54][55][56] sarcoidosis, 57 mitral stenosis secondary to rheumatic coronary arteritis, 58 fibromuscular dysplasia, 23, 59 cocaine use, 60,61 old age with and without CAD, 19,62 cardiopulmonary resuscitation, 3 copper deficiency causes, 36 apical hypertrophic cardiomyopathy and cryoglobulinemia associated with hepatitis C virus, 63 and hypertension. 4,64 …”

Section: Etiology and Pathogenesismentioning

confidence: 99%

“…44 Thrombolytic therapy is relatively contraindicated in SCAD due to the potential risk of worsening the dissection. 54,72,73 There are limited data on the utilization of newer antiplatelet agents such as glycoprotein IIb/IIIa inhibitors in SCAD. Cheung et al 51 reported successful use of glycoprotein IIb/IIIa inhibitor therapy with resolution of dissection, observed by angiography, within 20 h. Treatment with percutaneous coronary balloon angioplasty alone has been reported; [74][75][76][77][78] however, intracoronary stenting may be the preferred percutaneous treatment modality for patients with singlevessel SCAD, not involving the LMCA, and in patients who present with acute coronary syndromes or recurrent ischemia, due to the potential for the stent to obliterate the false lumen.…”

Section: Treatmentmentioning

confidence: 99%

Spontaneous coronary artery dissection

Almeda

Barkatullah

Kavinsky

2004

Clinical Cardiology

101

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Summary: Spontaneous coronary artery dissection (SCAD)is an unusual cause of acute myocardial ischemia with complex pathophysiology. This paper reviews the major diagnostic and therapeutic issues of this rare but important disease. The diagnosis of SCAD should be strongly considered in any patient who presents with symptoms suggestive of acute myocardial ischemia, particularly in young subjects without traditional risk factors for coronary artery disease (especially in young women during the peripartum period or in association with oral contraceptive use). Urgent coronary angiography is indicated to establish the diagnosis and to determine the appropriate therapeutic approach. The decision to pursue medical management, percutaneous coronary intervention, or surgical revascularization is based primarily on the clinical presentation, extent of dissection, and amount of ischemic myocardium at risk.

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Spontaneous coronary artery dissection in young women

Cited by 38 publications

References 17 publications

Exercise-induced coronary artery dissection in a 54-year-old male without atherosclerosis: A case report

Exercise-induced coronary artery dissection in a 54-year-old male without atherosclerosis: A case report

Spontaneous Coronary Artery Dissection Manifested during Ergonovine Test and Treated with Intravascular Ultrasound Guided Stenting: A Case Report

Spontaneous coronary artery dissection

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