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[Primary isolated dissection of the left anterior descending coronary artery]
O Montagne1, G Pochmalicki, F Jan
1Service de cardiologie, hôpital Henri-Mondor, Créteil.
Insights
A young man experienced myocardial infarction due to left anterior descending artery dissection. Successful fibrinolysis led to recovery and angiographic regression, suggesting a link to abnormal elastic tissue proliferation.
Area of Science:
- Cardiology
- Vascular Biology
- Dermatology
Background:
- Acute myocardial infarction (MI) in young adults without risk factors is uncommon.
- Coronary artery dissection is a rare cause of MI, particularly in men.
- Connective tissue disorders can predispose individuals to vascular events.
Observation:
- A 30-year-old Senegalese man presented with acute antero-septo-apical myocardial infarction.
- Coronary angiography revealed dissection of the left anterior descending artery.
- Skin biopsy showed abnormal proliferation of elastic tissues.
Findings:
- The patient underwent successful fibrinolysis within 5 hours of symptom onset.
- Eight months post-MI, the patient was asymptomatic with complete angiographic regression of the dissection.
- This case highlights a potential link between elastic tissue disease and spontaneous coronary artery dissection.
Implications:
- Early fibrinolysis can lead to favorable outcomes in spontaneous coronary artery dissection-induced MI.
- Understanding the role of elastic tissue abnormalities may offer new insights into managing vascular diseases.
- This case expands the literature on spontaneous coronary artery dissection in young men and its potential underlying mechanisms.
Abstract:
The authors report the case of a 30 year old Senegalese man admitted with an acute antero-septo-apical myocardial infarction which was fibrinolysed at the 5th hour. Coronary angiography showed dissection of the left anterior descending artery. This young patient with no previous medical history or cardiovascular risk factors had an abnormal skin biopsy showing proliferation of the elastic tissues. Eight months after the infarct the patient is asymptomatic and the appearances of dissection have disappeared. This case is original because the dissection occurred in a man, affecting the left anterior descending artery, with a good outcome after fibrinolysis (4th case), the angiographic regression of the arterial lesion and the possible pathogenetic mechanism of disease of elastic tissues.