Primary coronary artery dissection possibly related to drug hypersensitivity in a male

Primary coronary artery dissection is rare, usually affects females (greater than 85%), and has most often affected the left anterior descending coronary artery. The authors report a case that is unusual in four respects: the patient was male, the involved artery was a marginal branch of the circumflex, the resulting small infarct ruptured, and most importantly, the patient had recently experienced a drug hypersensitivity reaction. The microscopic finding of a heavy eosinophil and mast cell infiltrate around the dissected artery may indicate that dissection occurred as a result of hypersensitivity angiitis of the vasa vasorum, as has previously been suggested in the literature.