[Coronary artery dissection in young adults]

Area of Science:

• Cardiology
• Vascular Biology

Background:

• Acute myocardial infarction (MI) typically affects older individuals with cardiovascular risk factors.
• Spontaneous coronary artery dissection (SCAD) is an uncommon cause of MI, often presenting similarly to plaque rupture.

Observation:

• Two young patients, a male (23) and a female (30, smoker), presented with acute MI.
• The male experienced chest pain during exertion; the female had preceding chest pain and ventricular fibrillation.
• Both patients underwent primary percutaneous coronary intervention for SCAD.

Findings:

• SCAD is a rare cause of MI and sudden cardiac death, predominantly in young women.
• Associated factors include pregnancy, collagen diseases, substance abuse, hypertension, smoking, and intense exercise.
• SCAD presentation is often indistinguishable from atherosclerotic plaque rupture.

Implications:

• Early diagnosis and intervention are crucial for SCAD patients.
• Percutaneous coronary intervention is a viable treatment option for SCAD.
• Survivors of acute SCAD events generally have favorable long-term prognoses.