title: Spontaneous coronary artery dissection: a rare cause of acute coronary syndrome.
abstract: We present a case of a 71-year-old man, with a history of hypertension and dyslipidaemia, who presented with typical cardiac chest pain and palpitations of 2 h duration. The examination revealed irregular pulse of 138 bpm, blood pressure 115/75 mm Hg, variable first and normal second heart sounds. The lungs were clear to auscultation. The ECG showed atrial fibrillation with a rapid ventricular rate. His heart rate was controlled with β blockers and the acute coronary syndrome treatment protocol was initiated. His baseline blood reports were within normal limits and two serial troponin I tests were negative. Coronary angiogram showed dissection in the left coronary system extending into the branch vessels and 30-40% stenosis in the right coronary artery. The patient underwent coronary artery bypass graft as an emergent case. He suffered a mild stroke postsurgery with complete functional recovery. He is being followed up in the clinic and has performed well.
authors.affiliation: Department of Medicine, Aga Khan University, Karachi, Pakistan. drabidlaghari@yahoo.com
authors.forename: Abid Hussain
authors.initials: AH
authors.lastname: Laghari
authors.forename: Aamir Hameed
authors.initials: AH
authors.lastname: Khan
authors.forename: Khawar Abbas
authors.initials: KA
authors.lastname: Kazmi
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D001026:Coronary Artery Bypass; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D014652:Vascular Diseases / Q000150:complications / Q000151:congenital* / Q000503:physiopathology / Q000601:surgery
chemical_list: D000319:Adrenergic beta-Antagonists