Spontaneous coronary artery dissection in the context of positive anticardiolipin antibodies and clinically undiagnosed systemic lupus erythematosus

Lupus ◽  
2011 ◽  
Vol 20 (13) ◽  
pp. 1436-1438 ◽  
Author(s):  
MK Nisar ◽  
T Mya
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Coronary Artery ◽  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Case Reports ◽  
Anticardiolipin Antibody ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Systemic Lupus ◽  
Coronary Artery Dissection

Spontaneous coronary artery dissection (SCAD) is an extremely uncommon condition that can lead to fatal acute myocardial infarction. There have been very few case reports of SCAD in patients with systemic lupus erythematosus (SLE) and even fewer in association with antiphospholipid antibodies – mainly postpartum. This is the first reported case of SCAD in a patient who was confirmed to have SLE and tested positive for anticardiolipin antibody and lupus anticoagulant. This case demonstrates the importance of carefully considering the differential diagnoses of SCAD at presentation. It also highlights the need for further research to explore the link between SLE, antiphospholipid antibodies and SCAD.

scholarly journals Advances in the Research on Anticardiolipin Antibody

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Dan Wang ◽  
Wenxin Lv ◽  
Shichang Zhang ◽  
Jiexin Zhang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Endothelial Cell ◽  
Autoimmune Diseases ◽  
Spontaneous Abortion ◽  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Cell Membranes ◽  
Negative Charge ◽  
Anticardiolipin Antibody ◽  
Systemic Lupus

Anticardiolipin antibody (ACA) is a kind of autoantibody and is one of the antiphospholipid antibodies (aPLs). Phospholipids with a negative charge on platelets and endothelial cell membranes are ACA target antigens. ACA is common in systemic lupus erythematosus and other autoimmune diseases and is closely associated with thrombosis, thrombocytopenia, and spontaneous abortion. In 1983, Harris established a method for detecting ACA, and research on the antibody has gained worldwide attention and has developed rapidly. For this review, we browsed articles that cover most of the ACA-related studies in the last 25 years and extracted influential ideas and conclusions in this field.

Abstract 17082: Recurrent Multisite Spontaneous Coronary Artery Dissections in a Patient Using Prescription Amphetamine

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Likhitesh Jaikumar ◽  
Mehul Patel ◽  
Mandar Jagtap ◽  
Dakshin Gangadharamurthy ◽  
Theodore Richards ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Case Reports ◽  
Stable Condition ◽  
Young Female ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
History Of ◽  
Cardiac Catheterizations

Introduction: Spontaneous Coronary Artery Dissection (SCAD) is an uncommon condition. In patients taking prescription amphetamine or with methamphetamine abuse, SCAD has been reported in some case reports. We describe a case of a young female patient who had recurrent SCAD on prescription amphetamine with multisite involvement. Case presentation: A 48-year-old woman with history of active tobacco use, hypertension presented with substernal chest pain radiating to both arms. Her home medications included prescription amphetamine (Amphetamine, Dextroamphetamine) for reported history of ADHD (Attention Deficit Hyperactivity Disorder, diagnosed in childhood). The patient’s electrocardiogram showed ST elevations in V2,V3 and V4 and with reciprocal changes in leads II, III and aVF. On emergent cardiac catheterization we noted dominant left system with 99% occlusion with thrombus of mid LAD with radiolucent lumens and contrast dye extravasation into the arterial wall suggesting type 1 SCAD. Otherwise we noted normal RCA, LCx and OM branches. An IVUS was not used during the procedure. This lesion was revascularized with a drug eluding stent with containment of the dissection and achievement of TIMI 3 flow. We noted that the patient presented similarly two separate times in the past 2 years and cardiac catheterizations at that time revealed type 2B SCAD involving OM3, which appeared angiographically normal on current angiogram and 90% distal LAD occlusion from type 1 SCAD. The patient was treated with aspirin and ticagrelor and discharged 2 days post procedure in stable condition. Conclusions: Spontaneous Coronary Artery Dissection (SCAD) has been reported in patients with prescription amphetamine and methamphetamine use, but it is imperative to rule out alternative etiologies and amphetamine related SCAD should be a diagnosis of exclusion. We opted to intervene on the mid LAD dissection and the distal dissections were treated medically.

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