title: Spontaneous acute coronary dissection after cocaine abuse in a young woman.
abstract: Spontaneous coronary artery dissection is an unusual trigger for acute coronary syndrome or sudden death, occurring more frequently in relatively young people and mainly in the female sex. The underlying mechanism is not completely understood, but predisposing factors may include metabolism and collagen synthesis disorders. The case of a 34-year-old woman who underwent coronary angiography for acute anterolateral myocardial ischemia after cocaine abuse is reported. Dissection of the left main trunk extending to both proximal descending anterior and circumflex arteries was detected and the patient was promptly and successfully managed with tirofiban hydrochloride infusion and urgent coronary artery bypass grafting.
authors.affiliation: Istituto di Chirurgia Toracica, Cardiovascolare e Tecnologie Biomediche, Università degli Studi di Siena, Siena, Italy. Bizzarri@unisi.it
authors.forename: Federico
authors.initials: F
authors.lastname: Bizzarri
authors.forename: Sergio
authors.initials: S
authors.lastname: Mondillo
authors.forename: Francesco
authors.initials: F
authors.lastname: Guerrini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Barbati
authors.forename: Giacomo
authors.initials: G
authors.lastname: Frati
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Davoli
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000139:chemically induced* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D019970:Cocaine-Related Disorders / Q000150:complications*; D003323:Coronary Aneurysm / Q000139:chemically induced* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003937:Diagnosis, Differential; D004638:Emergency Treatment; D005260:Female; D006801:Humans