scholarly journals A Case Report on Spontaneous Coronary Artery Dissection Managed by Percutaeneous Coronary Intervention (PCI)

2021 ◽  
Vol 36 (2) ◽  
pp. 151-157
Author(s):  
Kajal Kumar Karmoker ◽  
Bijoy Dutta ◽  
Mohammad Bazlur Rashid ◽  
Mohammad Ashraful Alam ◽  
ABM Riaz Kawsar ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Treatment Guidelines ◽  
Coronary Intervention ◽  
Treatment Modalities ◽  
Drug Eluting Stent ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Conservative Strategy ◽  
Coronary Syndrome

Background: Spontaneous coronary artery dissection (SCAD) is frequently underdiagnosed and often considered as a rare cause of acute coronary syndrome (ACS). Although it predominantly affects young women in the peripartum period, it can also occur in men. Most of the reported dissections have occurred in the left anterior descending coronary artery. The optimal treatment modalities are yet to be defined. Case Summary: A 50- year-old man who presented to us at National Institute of Cardio-Vascular Diseases (NICVD), Dhaka with an acute Non-ST-elevation myocardial infarction secondary to a spontaneous dissection of the Left anterior descending coronary artery. Due to ongoing chest pain, percutaneous coronary intervention (PCI) was done with drug eluting stent (DES) successfully, and the patient was discharged from the hospital on medical therapy. Conclusion: All clinicians should remain vigilant and aware of this condition, as patient outcomes and treatment guidelines differ substantially from conventional atherosclerotic ACS. Although initial conservative strategy is preferred strategy in SCAD management but timely intervention is warranted in selected cases. Bangladesh Heart Journal 2021; 36(2): 151-157

scholarly journals A Case Report on Spontaneous Coronary Artery Dissection

2015 ◽  
Vol 5 (1) ◽  
pp. 52-57
Author(s):  
Tunaggina Afrin Khan ◽  
Abdul Wadud Chowdhury ◽  
Abu Sadique Abdullah
Keyword(s):  
Acute Coronary Syndrome ◽  
Case Report ◽  
Coronary Artery ◽  
Treatment Modalities ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Current Case ◽  
St Segment Elevation ◽  
Coronary Syndrome

Spontaneous coronary artery dissection is an extremely rare cause of acute coronary syndrome. Although it predominantly affects young women in the peripartum period, it can also occur in men. The left coronary artery is most frequently involved. The usual presentation is ST segment elevation myocardial infarction. Although several treatment modalities have been proposed, the optimal treatment options still remain to be established. This current case report focuses on a 40- year-old male presented with acute coronary syndrome and subsequently was found to have coronary artery dissection. DOI: http://dx.doi.org/10.3329/jemc.v5i1.21498 J Enam Med Col 2015; 5(1): 52-57

scholarly journals Spontaneous coronary artery dissection as a marker of undifferentiated connective tissue dysplasia: a case report

2021 ◽  
Vol 20 (7) ◽  
pp. 2973
Author(s):  
Ya. B. Khovaeva ◽  
A. L. Korovin ◽  
Ya. A. Sychugov ◽  
L. V. Ermachkova ◽  
N. P. Moiseenko
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Connective Tissue ◽  
Drug Eluting Stent ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Connective Tissue Dysplasia

The article presents a case report of spontaneous coronary artery dissection (SCAD) in the young woman with signs of undifferentiated connective tissue dysplasia (UCTD). The patient was admitted urgently with a clinical and electrocardiographic signs of acute ST-segment elevation coronary syndrome. The patient underwent a coronary angiography, which revealed a type D linear intimal dissection. The decision was made to perform balloon vasodilation with the placement of a drug-eluting stent. With multicomponent therapy, the patient’s condition improved. Physical examination revealed external markers of UCTD. Therefore, it was quantified by systems and organs. The patient had no other cardiovascular diseases, previous infection, or other trigger factors. She was discharged with recommendations to continue the prescribed therapy. This case report demonstrates SCAD as a rare cause of acute myocardial infarction in a young patient. The background for SCAD development in this case was UCTD. Algorithms for managing patients with SCAD against the background of UCTD have not been defined and require further study.

scholarly journals Pregnancy-associated spontaneous coronary artery dissection (PASCAD): An etiology for chest pain in the young peripartum patient

CJEM ◽  
2018 ◽  
Vol 20 (S2) ◽  
pp. S64-S69 ◽  
Author(s):  
Richard Lee ◽  
David Carr
Keyword(s):  
Chest Pain ◽  
Coronary Artery ◽  
Postpartum Period ◽  
Intramural Hematoma ◽  
Coronary Intervention ◽  
Treatment Modalities ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Traditional Risk Factors

AbstractCardiac emergencies in pregnancy and the postpartum period are rare but often life-threatening. An emergency physician’s differential diagnosis for chest pain in the peripartum patient often includes serious etiologies such as pulmonary embolism or myocardial infarction (MI). A lesser-known but important consideration on the differential for MI is that of a spontaneous coronary artery dissection (SCAD). SCAD is defined as an intramural hematoma within the coronary artery that compresses the true lumen. Expansion by increased pressures may lead to subsequent myocardial ischemia and infarction. This condition is the most common cause of pregnancy-associated MI and is reported as the cause of MI in 24% to 35% of all women younger than 50 years. This condition is predominately seen in young healthy females with no traditional risk factors for coronary artery or cardiac disease, and typically in the postpartum period. SCAD in the peripartum period is defined as pregnancy-associated spontaneous coronary artery dissection (PASCAD). Abnormal ECG changes, elevated troponins, and regional wall motional abnormalities on echocardiography are all diagnostic findings of SCAD, which can be ultimately confirmed with coronary angiography. Failure to immediately address this condition can lead to acute heart failure, cardiogenic shock, and death. Thrombolytic treatment may be harmful and is not recommended, and percutaneous coronary intervention can result in the iatrogenic propagation of further coronary dissection. As a result, the management for suspected SCAD involves emphasis on urgent transfer and urgent coronary artery angiography to determine appropriate treatment modalities.

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 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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