title: Spontaneous coronary artery dissection related to menstruation.
abstract: We present the case of a young woman who developed an acute onset of classic cardiac symptoms, but because of her age and lack of risk factors, had a significant delay in transfer for cardiac catheterization. She was found to have spontaneous dissection of the left coronary system, eventually requiring emergent bypass surgery. The patient had recently began her menstrual period, and we speculate that hormonal fluctuations contributed to this process. The role of hormonal influences on the coronary vasculature is not entirely understood, but the incidence of spontaneous coronary dissection is higher in women, and is usually related to changes in hormones such as pregnancy and oral contraceptive use. We review the literature on spontaneous coronary dissection, the influence of hormones on the vasculature, as well as diagnosis and treatment options.
authors.affiliation: Department of Cardiology, Geisinger Medical Center, Danville, PA 17822, USA. kaskelding@geisinger.edu
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Skelding
authors.forename: Cleon R
authors.initials: CR
authors.lastname: Hubbard
mesh_terms: D000077284:Abciximab; D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D006328:Cardiac Catheterization; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D008598:Menstruation / Q000502:physiology*; D009930:Organic Chemicals; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015607:Stents; D013997:Time Factors; D014654:Vascular Patency
chemical_list: D000911:Antibodies, Monoclonal; C113156:IRD 41 probe; D007140:Immunoglobulin Fab Fragments; D009930:Organic Chemicals; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab