scholarly journals Coronary artery dissection in the puerperium: A case report and literature review

2017 ◽  
Vol 11 (3) ◽  
pp. 144-147 ◽  
Author(s):  
Farshad Tahmasebi ◽  
Alice Hurrell ◽  
Amie Ford ◽  
Manish Gupta ◽  
Damien Geindreau ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Literature Review ◽  
Post Partum ◽  
False Lumen ◽  
Vasa Vasorum ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Coronary Syndrome ◽  
Increased Risk

Spontaneous coronary artery dissection is a rare but important cause of acute coronary syndrome. Its relevance for women during the puerperium mandates awareness and understanding amongst obstetric healthcare professionals. The aetiology of the increased risk in pregnancy has not been fully elucidated, but include medial eosinophilic angitis, pregnancy-induced degeneration of collagen in conjunction with the stresses of parturition, and rupture of the vasa vasorum. The risk of mortality necessitates prompt diagnosis, usually by angiography. There is no one-size-fits-all treatment; management must be individualised according to haemodynamic status and affected vessel(s) and includes conservative management, percutaneous coronary intervention, or bypass grafting. Recovery complications include extension of the haematoma or false lumen, valvular pathology secondary to ischaemia, and sudden cardiac death. Close post-operative surveillance is mandatory. We present a 41-year-old lady with post-partum spontaneous coronary artery dissection, complicated by ischaemic papillary rupture and mitral regurgitation requiring valve replacement. Additionally, we present a literature review, including guidance on management and critical analysis of potential complications.

scholarly journals Successful percutaneous treatment of occlusive spontaneous coronary artery dissection with a ‘pull-back injection technique’: case report

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Leire Unzue ◽  
Maria Jose Romero-Castro ◽  
Eulogio García ◽  
Leire Moreno
Keyword(s):  
Coronary Artery ◽  
False Lumen ◽  
Young Patients ◽  
Artery Dissection ◽  
Injection Technique ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Complete Occlusion ◽  
Coronary Syndrome ◽  
Distal Flow

Abstract Background Spontaneous coronary artery dissection (SCAD) is a rare condition that can cause acute coronary syndrome, typically in young patients without classical cardiovascular risk factors. Although in SCAD the conservative management is preferable, in cases with complete occlusion of the artery an invasive treatment may be required. In such cases, the goal of the percutaneous intervention should be to restore the connection between the true and false lumen recovering the distal flow of the vessel. Case summary A young man was admitted with acute chest pain and ST segment elevation in precordial v3–v6 leads. An emergent coronary angiogram showed an abrupt occlusion of middle left anterior descending artery compatible with SCAD. A microcatheter was advanced distally into the artery and pulled back with continuous contrast injection through the catheter, restoring the distal flow with a residual spiroid intimal flap and with relief of the chest discomfort. A computed tomography performed during admission showed complete resolution of the lesion. Discussion In SCAD with complete occlusion of the vessel, the ‘pull-back technique’ with continuous vigorous injection of contrast through a distal microcatheter may be effective to restore the distal flow enabling the healing of the artery at follow-up and avoiding the stent implant.

scholarly journals A Case of Spontaneous Coronary Artery Dissection in a Patient with Severe Anorexia Nervosa

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Jessica O’Neil ◽  
Soumyaa Mazumder ◽  
Danita Yoerger Sanborn ◽  
Samantha Wu
Keyword(s):  
Anorexia Nervosa ◽  
Case Report ◽  
Coronary Artery ◽  
Literature Review ◽  
Patient Population ◽  
Artery Dissection ◽  
Cardiac Complications ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Increased Risk

There are a variety of cardiac complications of anorexia nervosa including arrythmias, valvopathies, and myopathies. Spontaneous coronary artery dissection (SCAD) has not been widely reported among this patient population. This case report describes a middle-aged female with severe anorexia nervosa, who presented after being found unconscious, and was later diagnosed with SCAD. A literature review revealed one previous case of SCAD in a patient with anorexia nervosa and prompted a discussion of a series of possible predisposing factors for SCAD in this patient population. Patients with anorexia nervosa may be at increased risk for SCAD due to their complex nutritional and endocrine imbalances. This case highlights a possible underdiagnosed cardiac complication of anorexia nervosa.

scholarly journals Spontaneous Coronary Artery Dissection in a young male

2015 ◽  
Vol 3 ◽  
pp. 47
Author(s):  
Abhinav Saxena ◽  
Sameer Chadha ◽  
Ankur Lodha ◽  
Bilal Malik ◽  
Gerald Hollander ◽  
...  
Keyword(s):  
Coronary Artery ◽  
False Lumen ◽  
Young Male ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Font Size ◽  
Connective Tissue Disorders ◽  
Coronary Artery Dissection ◽  
Coronary Syndrome ◽  
The Media

<p style="background: white; margin: 0in 0in 0pt; text-align: justify;"><span style="color: black; font-family: 'Arial',sans-serif; font-size: 11pt; mso-fareast-font-family: 'Times New Roman';">Spontaneous coronary artery dissection is defined as a hemorrhagic separation of the media of the coronary artery with creation of a false lumen. It is an extremely rare clinical entity with an estimated incidence of around 0.1 - 0.2% in patients undergoing cardiac catheterization for acute coronary syndrome. It usually affects middle-aged females and is often associated with pregnancy, use of oral contraceptives, cocaine abuse, hypertension and connective tissue disorders. We describe a rare case of Spontaneous coronary artery dissection in a young male.</span></p>

scholarly journals Spontaneous coronary artery dissection of the proximal left circumflex artery: a case report

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Aleksandra Pineda ◽  
Josh Martin ◽  
Aniket Puri ◽  
Bijan Jahangiri
Keyword(s):  
Coronary Artery ◽  
Adverse Outcomes ◽  
Artery Dissection ◽  
Large Artery ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Syndrome ◽  
Increased Risk

Abstract Background Spontaneous coronary artery dissection (SCAD) has gained attention as an important cause of acute coronary syndrome and sudden cardiac death (SCD) among women. Management strategies of SCAD differ from those of atherosclerotic disease. There is an elevated risk of complications and suboptimal outcomes in patients with SCAD undergoing percutaneous coronary interventions (PCIs). Case summary A 48-year-old woman without any traditional cardiovascular risk factors was admitted with severe central chest pain with associated dyspnoea and diaphoresis. The patient had a strong family history of SCD, affecting three female members in their 40s and 50s. Cardiac troponins were elevated. Coronary angiogram showed moderate to severe stenosis of the proximal circumflex coronary artery. Optical coherence tomography confirmed SCAD with sub-intimal haematoma. Despite significant stenosis in the proximal segment of a relatively large artery, a decision was made not to proceed with PCI. The follow-up angiogram demonstrated normal coronaries. Magnetic resonance imaging of renal arteries showed features suggestive of fibromuscular dysplasia affecting the right renal artery. Subsequent genetic counselling and gene testing were unremarkable. Discussion Conservative management of SCAD is recommended because the large majority of SCAD lesions heal naturally, whereas PCI is associated with increased risk of complications and adverse outcomes. Whether SCAD is associated with the sudden death events in our patient’s family remains unclear. It certainly raises concerns as to an inheritable condition. In the absence of post-mortem findings in her family members, we can only speculate about this representing a possible inheritable form of SCAD.

scholarly journals Role of Imaging in Spontaneous Coronary Artery Dissection – A Report and Review of Literature

2016 ◽  
Vol 02 (02) ◽  
pp. 62
Author(s):  
Jagadeesh K Kalavakunta ◽  
Mohammad Hajjar ◽  
Rakshita Chandrashekar ◽  
Yashwant Agrawal ◽  
Nandu Gourineni ◽  
...  
Keyword(s):  
Chest Pain ◽  
Coronary Artery ◽  
Young Women ◽  
Post Partum ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Coronary Syndrome ◽  
First Case ◽  
Post Partum Period

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute ischaemic coronary events. It usually occurs during pregnancy or in the post-partum period in young women who have no traditional risk factors for coronary artery disease. We present two cases of SCAD in post-partum young women, who presented acutely with chest pain. Both underwent coronary angiography after worsening cardiac biomarkers. We utilised intravascular ultrasound (IVUS) in the first case, and optical coherence tomography (OCT) in the second case in order to confirm the diagnosis, define the anatomy and to measure the lesion length. This also serves to review the current literature and the available guidelines for treatment options for SCAD. We conclude that it is important to suspect SCAD as a cause of acute coronary syndrome in young female patients who present with chest pain especially in the post-partum period. These case studies also suggest a valuable role for IVUS and/or OCT in suspected cases of SCAD. This imaging is helpful in confirmation of the diagnosis, and allows optimal and precise treatment.

Spontaneous coronary artery dissection in association with cabergoline therapy

2021 ◽  
Vol 14 (2) ◽  
pp. e240022
Author(s):  
Zia Saleh ◽  
Susan Koshy ◽  
Vaninder Sidhu ◽  
Andrea Opgenorth ◽  
Janek Senaratne
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Cardiac Risk ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Coronary Syndrome ◽  
Ergot Derivative

Spontaneous coronary artery dissection (SCAD) is a rare but increasingly recognised cause of acute coronary syndrome. While numerous risk factors are associated with SCAD, one potential cause is coronary artery vasospasm. The use of cabergoline—an ergot derivative and dopamine agonist that may induce vasospasm—has been associated with SCAD in one other case report worldwide. Here, we describe SCAD in a 37-year-old woman on long-term cabergoline therapy with no other cardiac risk factors. Cabergoline-induced SCAD should be considered in patients presenting with an acute coronary syndrome who are treated with this medication.

scholarly journals Spontaneous Coronary Artery Dissection: Case Series and Literature Review

Cureus ◽  
2021 ◽  
Author(s):  
Nouraldeen Manasrah ◽  
Ali F Al Sbihi ◽  
Kendall Bell ◽  
Luis C Afonso ◽  
Nimrod Blank
Keyword(s):  
Coronary Artery ◽  
Literature Review ◽  
Case Series ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection

scholarly journals Recurrent Spontaneous Coronary Artery Dissection in 4 Vascular Territories

2018 ◽  
Vol 45 (2) ◽  
pp. 106-109
Author(s):  
Nader Makki ◽  
Poorvi Dalal ◽  
Quinn Capers ◽  
Ernest Mazzaferri ◽  
Talal Attar
Keyword(s):  
Coronary Artery ◽  
Artery Bypass ◽  
Premenopausal Women ◽  
Rare Condition ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Coronary Syndrome ◽  
Coronary Events ◽  
Multiple Episodes

Spontaneous coronary artery dissection, a rare cause of acute coronary syndrome, is due to nonatherosclerotic coronary events and is probably underrecognized as a cause of myocardial infarction. The condition typically affects premenopausal women who are otherwise healthy. Among more than 1,200 reported cases, recurrent dissection has been described 63 times, and only 3 reports have documented multiple episodes of dissection involving different vascular territories. We present the case of a woman in her 30s who, over a 9-year period, presented 4 times with coronary dissection in different vascular territories. She was first treated conservatively, then with stents, and ultimately by means of coronary artery bypass grafting. In addition to this case, we discuss this rare condition and its management.

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