The Self Sabotaging Vessel: A Case Report and Literature Review of Spontaneous Coronary Artery Dissection

Cureus. 2021 Dec 30;13(12):e20835. doi: 10.7759/cureus.20835. eCollection 2021 Dec.

Abstract

Spontaneous coronary artery dissection (SCAD) is a very rare cause of acute coronary syndrome. Despite the recent advances in the management of cardiovascular diseases, the diagnoses and management of SCAD remain a dilemma. It has been described to majorly affect females of childbearing age, immediately post-partum or on oral contraceptives. Recent cases have also identified underlying connective tissue disease as a risk factor. Since its discovery, only a limited number of cases affecting males have been reported in the literature. This makes our case unique. In this, we present a 31-year-old male without any traditional risk factors who presented with atypical chest pain. Electrocardiogram showed ST-segment changes with echocardiogram revealing apical left ventricular akinesis. A diagnostic left heart catheterization showed multiple lumens in the distal left anterior descending artery (LAD). The patient was managed conservatively and discharged home on guideline-directed medical therapy.

Keywords: interventional cardiology; myocardial infarction; primary percutaneous coronary intervention (pci); scad; spontaneous coronary artery dissection.

Publication types

  • Review