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[Two cases of primary artery dissection].

Y Kawahara1, K Hasegawa, S Inoue

  • 1Department of Cardiology, Kawasaki Medical School.

Kokyu to Junkan. Respiration & Circulation
|March 1, 1990
PubMed
Summary

Primary coronary artery dissection is a rare condition. This report details two cases, one potentially linked to vasospastic angina, highlighting diagnostic challenges and clinical presentations.

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Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Vascular Medicine

Background:

  • Primary coronary artery dissection (PCAD) is a rare cardiovascular emergency.
  • Diagnosis typically relies on coronary angiography, with limited reported cases.

Observation:

  • Case 1: A 55-year-old male with chest oppression diagnosed with angina pectoris and coronary spastic syndrome, revealed PCAD in the right coronary artery via angiography.
  • Case 2: A 27-year-old female presenting with back pain and ST-segment elevation myocardial infarction, diagnosed with PCAD in the left anterior descending artery.

Findings:

  • Coronary angiography confirmed intimal flap and false lumen in Case 1, and dissection at segment 6 in Case 2.
  • The clinical presentation in Case 2 mirrored previously reported instances of PCAD.

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Implications:

  • PCAD requires high index of suspicion for accurate diagnosis, especially in younger patients or those with atypical symptoms.
  • Potential association between vasospastic angina and PCAD warrants further investigation.
  • This case series contributes to the limited literature on PCAD, aiding in understanding its diverse manifestations.