scholarly journals A Rare Case: ST Segment Elevation Myocardial Infarction due to Spontaneous Extensive Left Coronary Artery Dissection

2016 ◽  
Vol 24 (2) ◽  
pp. 118-122
Author(s):  
Taner ŞEKER ◽  
Ahmet Oytun BAYKAN ◽  
Mustafa GÜR ◽  
Alaa QUISI ◽  
Murat ÇAYLI
2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Tatsuo Haraki ◽  
Ryota Uemura ◽  
Shin-ichiro Masuda ◽  
Takeshi Lee

Spontaneous coronary artery dissection (SCAD) is a rare condition that may have a serious outcome because of acute coronary syndrome. The condition especially affects young women. We evaluated a middle-aged male patient with a non-ST segment elevation myocardial infarction caused by multivessel SCAD. The SCAD had occurred in the distal right coronary artery (RCA), the mid left anterior descending artery (LAD), and the distal LAD at the same time. His culprit lesion was in the distal RCA, but the SCAD had progressed more proximally within the RCA 12 days later with no clinical symptoms. We treated the mid LAD with implantation of a drug-eluting stent on admission and the SCAD had not progressed 12 days later. Moreover, the SCAD in the distal RCA and distal LAD healed spontaneously 12 days later. He had no recurrent attack, and all SCAD lesions of the RCA and LAD had completely healed 6 months later. Given that SCAD appears in various forms over the clinical course, a strategy of intervention needs careful consideration.


2015 ◽  
Vol 42 (5) ◽  
pp. 479-482 ◽  
Author(s):  
Anne C.H. Goh ◽  
Robert J. Lundstrom

Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome. Clinical presentation ranges from chest pain alone to ST-segment-elevation myocardial infarction, ventricular fibrillation, and sudden death. The treatment of patients with spontaneous coronary artery dissection is challenging because the disease pathophysiology is unclear, optimal treatment is unknown, and short- and long-term prognostic data are minimal. We report the case of a 70-year-old woman who presented with an acute ST-segment-elevation myocardial infarction secondary to a spontaneous dissection of the left anterior descending coronary artery. She was treated conservatively. Cardiac tamponade developed 16 hours after presentation. Repeat coronary angiography revealed extension of the dissection. Medical therapy was continued after the hemopericardium was aspirated. The patient remained asymptomatic 3 years after hospital discharge. To our knowledge, this is the first reported case of spontaneous coronary artery dissection in association with cardiac tamponade that was treated conservatively and had a successful outcome.


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