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Simultaneous and spontaneous multivessel coronary artery dissection presenting as congestive heart failure

Yong-Hyun Kim1, Seong-Hwan Kim, Sang-Yeob Lim

  • 1Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, 126-1, Go-jang-dong, Dan-won-gu, Ansan, 425-707, South Korea.

Heart and Vessels
|December 25, 2010
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) is rare, and multivessel SCAD even rarer. This case highlights a unique presentation of congestive heart failure, not acute coronary syndrome, in a patient with multivessel SCAD.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Spontaneous coronary artery dissection (SCAD) is an uncommon cause of myocardial ischemia.
  • Multivessel SCAD, affecting multiple coronary arteries simultaneously, is significantly rarer than single-vessel SCAD.
  • Acute coronary syndrome is the typical clinical presentation for SCAD patients.

Observation:

  • This report details a rare case of SCAD affecting both the left anterior descending and right coronary arteries concurrently.
  • The patient's clinical presentation was characterized by congestive heart failure, deviating from the usual acute coronary syndrome presentation.

Findings:

  • Successful management involved angioplasty and stent placement for the multivessel SCAD.
  • The patient's congestive heart failure symptoms were effectively resolved through subsequent medical treatment.

Implications:

  • This case underscores the importance of considering diverse clinical presentations for SCAD, including heart failure.
  • It highlights the successful therapeutic approach for complex multivessel SCAD, leading to symptom resolution.
  • Further research into non-acute coronary syndrome presentations of SCAD may improve diagnostic and treatment strategies.

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