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Spontaneous coronary artery dissection: a review of the etiology and available treatment options

Andrew B McCann1, Robert J Whitbourn

  • 1Department of Cardiology, St. Vincent's Hospital, 41 Victoria Parade, Fitzroy, Vic., 3065, Australia. abmccann74@hotmail.com

Heart and Vessels
|January 29, 2010
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) can cause heart attacks. This case shows successful medical treatment and recovery for a young female runner with SCAD.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute myocardial infarction (AMI) and sudden cardiac death.
  • SCAD requires prompt recognition and appropriate management to prevent adverse cardiac events.

Observation:

  • A 36-year-old female runner presented with acute anterior ST-elevation myocardial infarction.
  • Coronary angiography identified spontaneous dissection in the left anterior descending and diagonal arteries.

Findings:

  • The patient received successful thrombolysis and was treated medically with warfarin and dual antiplatelet therapy.
  • Repeat angiography at 8 weeks demonstrated significant angiographic improvement.
  • Normal exercise stress testing at 10 months permitted a return to exercise.

Implications:

  • This case highlights the potential for successful medical management of SCAD in young, active individuals.
  • Complete recovery and return to full activity are achievable with appropriate treatment.
  • Further research into SCAD etiology and optimal treatment strategies is warranted.

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