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Spontaneous coronary artery dissection of all major coronary arteries

S Harikrishnan1, V K Ajithkumar, J M Tharakan

  • 1Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India. drharikrishnan@hotmail.com

The Canadian Journal of Cardiology
|March 24, 2007
PubMed

Insights

Spontaneous coronary artery dissection is a rare cause of heart attack and sudden death. This case describes a young man with widespread coronary dissection, treated medically after refusing surgery.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome.
  • SCAD can lead to myocardial infarction and sudden cardiac death, particularly in younger individuals.

Observation:

  • A 32-year-old male presented with exertional angina.
  • Diagnostic workup included a positive exercise electrocardiogram test.
  • Coronary angiography revealed dissection in all major coronary arteries, with complete occlusion of the left anterior descending artery.

Findings:

  • The patient exhibited extensive spontaneous coronary artery dissection affecting multiple vessels.
  • The left anterior descending artery occlusion was likely a consequence of the dissection process.
  • Medical management was chosen over surgical intervention due to patient preference.

Implications:

  • This case highlights the potential for widespread SCAD in young adults.
  • It underscores the importance of considering SCAD in the differential diagnosis of angina and myocardial infarction.
  • Conservative medical management can be an alternative to revascularization in selected SCAD cases.

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