Spontaneous coronary artery dissection: the management dilemma continues.
Spontaneous coronary artery dissection (SCAD) is an increasingly recognised cause of acute coronary syndrome, particularly in women. A 36-year-old Caucasian woman presented to our hospital with sudden onset chest pain and was diagnosed with a non-ST elevation myocardial infarction. Coronary angiography revealed mid and distal left anterior descending artery (LAD) dissection with distal LAD occlusion. A short segment of apical LAD filled late with incomplete opacification (Thrombolysis In Myocardial Infarction (TIMI) 1 flow). A decision was made to treat the patient conservatively, with subsequent resolution of dissection over the next 3 months. Our patient made a good clinical recovery with healing of her affected coronary vasculature on subsequent angiogram. The case illustrates that SCAD can be managed conservatively with antiplatelet agents, β-blockers, heparin and statins, if the patient is haemodynamically stable and coronary flow is adequate.
Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
Zaheer
Z
Ahmed
Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
Ata
A
Bajwa
University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
Bhaskar
B
Bhardwaj
University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA Mid America Heart Institute, St Luke's Hospital, Kansas City, Missouri, USA.
Steven B
SB
Laster
University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA Mid America Heart Institute, St Luke's Hospital, Kansas City, Missouri, USA.
Anthony
A
Magalski
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