Related Experiment Video

Updated: Jul 15, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
06:39

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders

Published on: August 18, 2016

Spontaneous coronary artery dissection in a woman on fenfluramine

Anil K Goli1, Madhav Koduri, Tariq Haddadin

  • 1Division of Electrophysiology, Case Western Reserve University, Cleveland, Ohio, USA.

Reviews in Cardiovascular Medicine
|April 3, 2007
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) is a rare cause of sudden cardiac death in women. This case highlights SCAD in a 39-year-old woman, emphasizing the need for better understanding and management of this condition.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Women's Health

Background:

  • Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS), particularly in women of reproductive age without traditional cardiovascular risk factors.
  • The underlying mechanisms, long-term prognosis, and optimal treatment strategies for SCAD are not well-established, necessitating further research and clinical investigation.

Observation:

  • A case of SCAD is presented in a 39-year-old woman who experienced ST-elevation myocardial infarction (STEMI) during the midpoint of her menstrual cycle.
  • The patient was taking fenfluramine for obesity and a combination of hydrochlorothiazide, amlodipine, and atenolol for hypertension.

Findings:

  • Coronary angiography confirmed the diagnosis of SCAD, which is considered the gold standard for identifying this condition.
  • Potential mechanisms for SCAD include atherosclerotic plaque or vasa vasorum rupture, intramedial hematoma expansion, and lumen compression.

Implications:

  • This case underscores the importance of considering SCAD in the differential diagnosis of ACS in young women, even in the absence of typical risk factors.
  • Further research into the etiology and management of SCAD is crucial for improving patient outcomes and reducing the incidence of cardiogenic shock and sudden cardiac death.

More Related Videos

Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm06:18

Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm

Published on: September 17, 2021

Related Concept Videos

Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
Flail Chest-I01:24

Flail Chest-I

Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...