Survival with acute primary coronary artery dissection: A case report and review of the literature

Spontaneous coronary artery dissection is an extremely rare cause of myocardial infarction. The prognosis and treatment of coronary artery dissection have not yet been defined. We report on a 42-year-old woman who was admitted to the emergency unit of a regional hospital with central chest pain and electrocardiographic signs of extensive acute anterior myocardial infarction (MI). She was treated with thrombolytics, yet her condition deteriorated rapidly, resulting in cardiogenic shock. An angiogram revealed dissection of the left main coronary artery that extended into the anterior descending (LAD) and circumflex arteries (LCX). At autopsy a recent anterolateral MI of the left ventricle was found. Dissection of the left coronary artery system was confirmed. Extension of the dissection may have been due to thrombolytic treatment.

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Double vessel extension of spontaneous left main coronary artery dissection in young women treated with thrombolytics

Zupan

Noč

Trinkaus

et al. 2001

Cathet. Cardiovasc. Intervent.

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Spontaneous multivessel coronary artery dissection: Repeated presentation in a healthy postmenopausal woman

Judkins

Capone

Houghton

et al. 1999

Clinical Cardiology

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Summary:Spontaneous coronary artery dissection is a rare cause of acute myocardial infarction which is infrequently diagnosed antemortem. Most previously reported cases were found in women of whom a significant proportion presented during pregnancy or the postpartum period. We describe the first antemortem case of spontaneous coronary artery dissection, unrelated to pregnancy or the postpartum state, which ultimately resulted in diffuse involvement of both the left and right coronary arteries over a period of 4 months. Pathophysiology and case management of this disorder are discussed.

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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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Survival with acute primary coronary artery dissection: A case report and review of the literature

Cited by 9 publications

References 41 publications

Double vessel extension of spontaneous left main coronary artery dissection in young women treated with thrombolytics

Double vessel extension of spontaneous left main coronary artery dissection in young women treated with thrombolytics

Spontaneous multivessel coronary artery dissection: Repeated presentation in a healthy postmenopausal woman

Spontaneous coronary artery dissection

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