Spontaneous coronary artery dissection in a young woman without risk factors

Spontaneous coronary artery dissection is a very rare event and is more common in women than in men. Pregnancy and the early puerperium stage have been recognized as predisposing factors for this condition.

A 33-year-old woman presented to the Emergency Department (ED) with chest pain; the patient's electrocardiogram (ECG) showed an ST-segment elevation similar to that observed in ST-segment elevation myocardial infarction (STEMI). She experienced a ventricular fibrillation cardiac arrest when she was in the hospital and received resuscitation, after which she regained consciousness and showed spontaneous circulation. She underwent cardiac catheterization under the impression of spontaneous coronary artery dissection, and conservative therapy was chosen.

In this report, we have underlined the importance of considering coronary artery dissection in the differential diagnosis of young women who present to the ED with chest pain, an ECG with ST-segment elevation, and very few cardiac risk factors.