title: Spontaneous coronary artery dissection: Still a lot to learn.
abstract: Non-atherosclerotic spontaneous coronary artery dissection (SCAD) is an uncommon but probably underdetected pathological substrate for acute coronary syndrome. Clinical associations have been noted, like female gender and young age, but its pathophysiology is not yet fully understood. In this report we describe the case of a 50-year-old woman, without cardiovascular risk factors presenting with non-ST segment elevation myocardial infarction, in whom SCAD was diagnosed. Treatment was initially conservative but due to aggravation of the dissection she eventually underwent a complex percutaneous coronary intervention, requiring implantation of multiple stents, but with a good clinical outcome. The procedure was guided by optical coherence tomography (OCT). Carefully analyzing the combined pictures of OCT and angiography, the dissection appeared to be filled with a clear fluid, but not contrast.
authors.affiliation: Serviço de Cardiologia, Hospital Espírito Santo, Évora, Portugal. Electronic address: dcneves25@hotmail.com.
authors.forename: David
authors.initials: D
authors.lastname: Neves
authors.affiliation: Serviço de Cardiologia, Hospital Espírito Santo, Évora, Portugal.
authors.forename: Ângela
authors.initials: Â
authors.lastname: Bento
authors.affiliation: Serviço de Cardiologia, Hospital Espírito Santo, Évora, Portugal.
authors.forename: Renato
authors.initials: R
authors.lastname: Fernandes
authors.affiliation: Serviço de Cardiologia, Hospital Espírito Santo, Évora, Portugal.
authors.forename: Lino
authors.initials: L
authors.lastname: Patrício
authors.affiliation: Serviço de Cardiologia, Hospital Espírito Santo, Évora, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Aguiar
mesh_terms: D003330:Coronary Vessel Anomalies / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D014652:Vascular Diseases / Q000151:congenital* / Q000175:diagnosis
keywords: Angioplastia coronária; Disseção coronária espontânea; Optical coherence tomography; Percutaneous coronary intervention; Spontaneous coronary artery dissection; Tomografia de coerência óptica