title: Spontaneous coronary dissection of all three coronary arteries: a case description with medium-term angiographic follow-up.
abstract: Spontaneous coronary artery dissection is a rare cause of ischemic heart disease, often related with a poor prognosis. We report the case of a 38-year-old woman without cardiovascular risk factors, admitted to our coronary care unit for unstable angina with ECG findings of inferior ischemia. The day after, an acute anterior myocardial infarction occurred and was treated with intravenous thrombolysis. Again, there were ECG signs of transient inferior ischemia. Coronary angiography showed widespread spontaneous coronary dissection involving the terminal left main stem, both the left anterior descending and circumflex artery, and the right coronary artery even peripherally, rendering any type of revascularization procedure inappropriate. The patient was placed on beta-blockers, acetylsalicylic acid and nitrates and her symptoms resolved; the 17-month angiographic follow-up showed almost complete healing of spontaneous coronary artery dissection. The peculiarities of the case are discussed and a review of the literature is provided.
authors.affiliation: Cardiac Catheterization Laboratory, Department of Cardiology, S. Maria delle Croci Hospital, Ravenna, Italy. ra.hocardio@ausl.ra.it
authors.forename: Aleardo
authors.initials: A
authors.lastname: Maresta
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Varani
authors.forename: Marco
authors.initials: M
authors.lastname: Balducelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vecchi
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003323:Coronary Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications