Spontaneous coronary artery dissection of the left circumflex artery causing cardiac tamponade and presenting with atrial fibrillation: a case report and review of the literature.
Spontaneous coronary artery dissection is rare. When it does occur, it can present in a myriad of ways and can mimic more common clinical scenarios. Undiagnosed it can be fatal. In this article, the authors present a case of coronary artery dissection in a middle aged man presenting as fast atrial fibrillation with hemodynamic compromise. He was unsuccessfully cardioverted and later arrested and died. Postmortem showed a ruptured dissection of the left circumflex artery causing cardiac tamponade and death. Incidence, associations, pathophysiology, investigations, and treatment options are reviewed.
Hayes
Christopher R
CR
Hereford Hospital NHSTrust, Herefordshire, United Kingdom. chrisruhayes@doctors.org.uk
Lewis
Debbie
D
D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D001281:Atrial Fibrillation / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D002305:Cardiac Tamponade / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D003323:Coronary Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D003331:Coronary Vessels / Q000473:pathology; D003951:Diagnostic Errors; D004554:Electric Countershock; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous