title: Syncope with spontaneous coronary artery dissection in an elderly woman.
abstract: Diagnosis of spontaneous coronary artery dissection (SCAD) is challenging because of its rarity and uncertain etiology. It frequently occurs in young women during pregnancy and in the postpartum period, and rarely found in elder women with no history of cardiovascular disease or coronary risk factors. In this article we report a case of SCAD in a 75-year-old woman without traditional cardiovascular risk factors who presented with syncope and mild chest discomfort. There were no abnormal electrocardiographic changes and no elevated cardiac enzymes were detected. Computed tomography of brain revealed nothing abnormal. Coronary artery disease was suspected. Coronary angiogram revealed dissection in the middle left circumflex artery. The patient underwent percutaneous transluminal coronary angioplasty and was free of symptoms at 6-month follow-up. Our report suggests that emergency coronary angiography is indicated if syncope caused by coronary artery disease is suspected.
authors.affiliation: Division of Internal Cardiology, Taichung Armed Forces General Hospital, and Central Taiwan University of Science and Technology, Taichung, Taiwan, China.
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Chen
authors.forename: Mu-Hsin
authors.initials: MH
authors.lastname: Chang
authors.forename: Ting-Chuan
authors.initials: TC
authors.lastname: Chang
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Lai
authors.forename: Gwo-Ping
authors.initials: GP
authors.lastname: Jong
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003323:Coronary Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D005260:Female; D006801:Humans