Spontaneous coronary artery dissection mimicking acute aortic dissection

Area of Science:

• Cardiology
• Vascular Medicine
• Pathophysiology

Background:

• Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS) and sudden cardiac death.
• SCAD predominantly affects women and often occurs without traditional cardiovascular risk factors.
• The exact etiology and pathogenesis of SCAD remain incompletely understood, with hypertension not typically considered a primary factor.

Observation:

• This report details a case of SCAD in the proximal right coronary artery.
• The patient exhibited symptoms and signs consistent with acute aortic dissection.
• The co-occurrence of SCAD and signs of aortic dissection is a notable clinical presentation.

Findings:

• The case suggests a potential link between hypertension and the pathogenesis of SCAD.
• This finding challenges the conventional understanding of SCAD's contributing factors.
• The association between SCAD and acute aortic dissection symptoms warrants further investigation.

Implications:

• Hypertension may be a more significant contributing factor to SCAD than previously recognized.
• This case highlights the importance of considering SCAD in patients presenting with ACS, especially women, even in the absence of typical risk factors.
• Further research is needed to elucidate the role of hypertension and potential shared pathways in SCAD and aortic dissection.