Persistent spontaneous dissection of the left anterior descending coronary artery after emotional pressure
Agnes Mayr1, Gert Klug, Werner Jaschke
1Clinical Department of Radiology I, Medical University Innsbruck, Innsbruck, Austria.
Insights
Spontaneous coronary artery dissection (SCAD) can cause heart attacks. This case shows a woman with SCAD treated conservatively, who remained symptom-free with no signs of ischemia despite persistent dissection.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial infarction, often affecting younger women without traditional cardiovascular risk factors.
- Early diagnosis and appropriate management are crucial for favorable outcomes in SCAD patients.
Abstract:
A 51-year-old woman without cardiovascular risk factors experienced severe chest pain, accompanied by ST-segment elevation in lead II, III, AVF, and V4-V6. An immediately started thrombolytic therapy in a peripheral hospital successfully eliminated the cardiac symptoms and achieved complete ST-segment resolution. Subsequent cardiac angiography revealed a longitudinal spontaneous dissection in the distal part of the left anterior descending artery. Due to the small vessel size we decided on conservative therapeutic procedure with acetyl salicylamide, clopidogrel, statin, and beta blocker. Three months later, control angiography presented no resolution of the dissection and the patient showed excellent performance on stress test with no signs of ischemia.
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