Spontaneous coronary artery dissection presenting as acute myocardial infarction

Area of Science:

• Cardiology
• Vascular Medicine

Background:

• Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute myocardial infarction (AMI).
• It disproportionately affects young, low-risk female patients.
• Idiopathic SCAD presents a diagnostic and therapeutic challenge.

Observation:

• A case report of a Black female patient experiencing an acute anterior wall myocardial infarction.
• The infarction was attributed to spontaneous coronary artery dissection of the left anterior descending artery.
• The patient presented with symptoms suggestive of a heart attack.

Findings:

• Coronary angiogram revealed an intimal tear and dissection in the left anterior descending artery.
• The patient received thrombolytic therapy during the acute phase without complications.
• Medical management for ischemic heart disease and left ventricular systolic dysfunction resulted in a favorable outcome.

Implications:

• This case reinforces the viability of thrombolytic therapy in managing acute myocardial infarction secondary to SCAD.
• It adds to the literature on SCAD survivors, particularly in diverse patient populations.
• Highlights the importance of considering SCAD in young women presenting with AMI, even with low traditional cardiac risk factors.