Spontaneous coronary artery dissection in a 27-year-old woman.
BACKGROUND
Spontaneous coronary artery dissection (SCAD) causes acute coronary syndromes or sudden death in young patients who are often lacking classic coronary disease risk factors. Systemic inflammatory and connective tissue diseases have been suggested as risk factors for SCAD.


OBJECTIVE
To review the risk factors, diagnosis, and management of this uncommon but life-threatening disease.


METHODS
We report a case of a 27-year-old woman with a history of an ill-defined inflammatory arthropathy who presented with an acute ST-elevation myocardial infarction. SCAD was diagnosed by coronary angiography. Percutaneous coronary intervention was attempted but was unsuccessful. The patient recovered uneventfully with medical management and was ultimately diagnosed with systemic lupus erythematosus.


CONCLUSIONS
SCAD is a rare but important cause of acute coronary syndromes and sudden death. It commonly occurs in young women. Although pregnancy is the most well-established risk factor, systemic inflammatory and connective tissue diseases have also been suggested as risk factors.
Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Bart R
BR
Besinger
Stephanie
S
Gardner
D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis* / Q000628:therapy; D002637:Chest Pain / Q000209:etiology; D003323:Coronary Aneurysm / Q000175:diagnosis* / Q000628:therapy; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis; D009203:Myocardial Infarction / Q000175:diagnosis; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors