Abstract
Spontaneous coronary artery dissection (SCAD) is an increasingly recognised cause of acute coronary syndrome, particularly in women. A 36-year-old Caucasian woman presented to our hospital with sudden onset chest pain and was diagnosed with a non-ST elevation myocardial infarction. Coronary angiography revealed mid and distal left anterior descending artery (LAD) dissection with distal LAD occlusion. A short segment of apical LAD filled late with incomplete opacification (Thrombolysis In Myocardial Infarction (TIMI) 1 flow). A decision was made to treat the patient conservatively, with subsequent resolution of dissection over the next 3 months. Our patient made a good clinical recovery with healing of her affected coronary vasculature on subsequent angiogram. The case illustrates that SCAD can be managed conservatively with antiplatelet agents, β-blockers, heparin and statins, if the patient is haemodynamically stable and coronary flow is adequate.
2015 BMJ Publishing Group Ltd.
MeSH terms
-
Adenosine / analogs & derivatives
-
Adenosine / therapeutic use
-
Adult
-
Anticholesteremic Agents / therapeutic use
-
Antihypertensive Agents / therapeutic use
-
Aspirin / therapeutic use
-
Atorvastatin / therapeutic use
-
Carbazoles / therapeutic use
-
Carvedilol
-
Coronary Angiography
-
Coronary Vessel Anomalies / complications
-
Coronary Vessel Anomalies / diagnosis*
-
Coronary Vessel Anomalies / drug therapy*
-
Diagnosis, Differential
-
Echocardiography
-
Electrocardiography
-
Female
-
Humans
-
Myocardial Infarction / complications
-
Myocardial Infarction / drug therapy
-
Myocardial Infarction / etiology
-
Platelet Aggregation Inhibitors / therapeutic use
-
Propanolamines / therapeutic use
-
Purinergic P2Y Receptor Antagonists / therapeutic use
-
Ticagrelor
-
Vascular Diseases / complications
-
Vascular Diseases / congenital*
-
Vascular Diseases / diagnosis
-
Vascular Diseases / drug therapy
Substances
-
Anticholesteremic Agents
-
Antihypertensive Agents
-
Carbazoles
-
Platelet Aggregation Inhibitors
-
Propanolamines
-
Purinergic P2Y Receptor Antagonists
-
Carvedilol
-
Atorvastatin
-
Ticagrelor
-
Adenosine
-
Aspirin
Supplementary concepts
-
Coronary Artery Dissection, Spontaneous