A complicated spontaneous left main coronary artery dissection. Is the initial conservative management safe in asymptomatic patients?
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome. Knowledge of this condition is scarce and, at present, no consensus exists with regards to the aetiology, prognosis, and treatment. Among patients with SCAD, cases involving the left main (LM) and the left anterior descending (LAD) and circumflex (Cx) arteries bifurcation are even more exceptional. Furthermore, the treatment of asymptomatic patients with involvement of these major vessels poses a major challenge for the cardiologists and cardiac surgeons. We report a case of complicated spontaneous left main coronary artery dissection in which we question what is the best initial treatment in these asymptomatic patients: conservative or early aggressive.
Cardiology Department, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, Madrid, Spain. alfonsojuradoroman@gmail.com
Alfonso
A
Jurado-Román
Javier
J
Andreu
Julio García
JG
Tejada
Maite
M
Velázquez
Agustín
A
Albarrán
Felipe
F
Hernández
Leire
L
Unzué
Juan
J
Tascón
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D011379:Prognosis