A Tale of Two Evils: Iatrogenic Propagation of Spontaneous Coronary Artery Dissection

Juan Enciso; Madeline Zipperer; Luke Casals; Daniela R Crousillat

doi:10.7759/cureus.45569

A Tale of Two Evils: Iatrogenic Propagation of Spontaneous Coronary Artery Dissection

Cureus. 2023 Sep 19;15(9):e45569. doi: 10.7759/cureus.45569. eCollection 2023 Sep.

Authors

Juan Enciso¹, Madeline Zipperer¹, Luke Casals¹, Daniela R Crousillat^{2

3}

Affiliations

¹ Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA.
² Heart and Vascular Institute, Tampa General Hospital, Tampa, USA.
³ Department of Cardiovascular Sciences, University of South Florida Morsani College of Medicine, Tampa, USA.

Abstract

Spontaneous coronary artery dissection (SCAD) is a non-traumatic and non-iatrogenic intimal separation of the coronary arterial wall. While poorly understood, its mechanism confers higher prevalence in younger females, and it is responsible for 25% of acute coronary syndromes (ACS) in women under 50 years of age. SCAD is primarily diagnosed via coronary angiography; however, intraluminal contrast injection and percutaneous coronary interventions (PCI) are associated with an increased risk of propagation and extension of the dissection leading to increased risk of morbidity and mortality. We present the case of a 48-year-old female with multivessel SCAD and subsequent iatrogenic dissection following contrast injection requiring multiple PCI for medical treatment of refractory cardiac angina.

Keywords: multivessel scad; recurrent spontaneous coronary artery dissection; scad; scad and fmd; scad management; spontaneous coronary artery dissection.

Publication types

Case Reports