Spontaneous coronary artery dissection: a review of the etiology and available treatment options.
Spontaneous coronary artery dissection is a rare cause of acute myocardial infarction and sudden cardiac death. We present a case of a 36-year-old female runner who was successfully thrombolysed for acute anterior ST elevation myocardial infarction. Coronary angiography revealed spontaneous dissection of the left anterior descending and diagonal arteries. The patient was treated medically with warfarin and dual antiplatelet therapy. Repeat angiography at 8 weeks showed significant angiographic improvement. Exercise stress testing at 10 months was normal and allowed a return to exercise. At 28 months the patient is asymptomatic and fully active. A review of the etiology and available treatment options is presented.
McCann
Andrew B
AB
Department of Cardiology, St. Vincent's Hospital, 41 Victoria Parade, Fitzroy, Vic., 3065, Australia. abmccann74@hotmail.com
Whitbourn
Robert J
RJ
D000328:Adult; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000925:Anticoagulants / Q000627:therapeutic use*; D003323:Coronary Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D017023:Coronary Angiography; D004359:Drug Therapy, Combination; D005080:Exercise Test; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012307:Risk Factors; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin